Facts, Views & Vision
in ObGyn

Journal of the European Society for Gynaecological Endoscopy

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Treatment algorithm in patients with ovarian cancer

I. Vergote 1, H. Denys 2, J. De Greve 3, C. Gennigens 4, K. Van De Vijver 5,6, J. Kerger 7, P. Vuylsteke 8, J.F. Baurain 8,9

1 Department of Oncology, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium;
2 Department of Medical Oncology, Ghent University Hospital, C. Heymanslaan 10, 9000 Ghent, Belgium;
3 Department of Medical Genetics, University Hospitals Brussels, Laarbeeklaan 101, 1090, Brussels, Belgium;
4 Department of Medical Oncology, Liège University Hospital, Avenue de l’Hôpital 1, 4000 Liège, Belgium;
5 Department of Pathology, Ghent University Hospital, C. Heymanslaan 10, 9000 Ghent, Belgium;
6 Department of Pathological Anatomy, Antwerp University Hospital, Universiteitsplein 1, 2610 Wilrijk, Belgium;
7 Jules Bordet Institute, Brussels University Hospital,Boulevard de Waterloo 121, 1000 Brussels, Belgium;
8 Department of Oncology, UCLouvain, CHU UCL Namur Hospital, Site St-Elisabeth, Place Louise Godin 15, 5000 Namur, Belgium;
9 Department of Oncology, St.-Luc University Hospital Brussels,Avenue Hippocrate 10, 1200 Woluwe-Saint-Lambert, Belgium.

Keywords:

Epithelial ovarian cancer, treatment algorithm, genetic testing, targeted agents


Published online: Oct 09 2020

Abstract

Most ovarian cancer patients are diagnosed only at advanced stages when survival outcomes are worse, and when therapeutic decisions might prove challenging. The fundamental treatment for women with ovarian cancer includes debulking surgery whenever possible and appropriate systemic therapy (chemotherapy, targeted and antiangiogenic agents). In the last few years, knowledge about histological and molecular characteristics of ovarian cancer subtypes and stages has increased considerably. This has enabled the development and improvement of several options for the diagnosis and treatment of ovarian cancer in a patient-tailored approach. Accordingly, therapeutic decisions are guided by the characteristics of the patient and the tumour, especially the molecular features of the cancer subtype and disease stage. Particularly relevant are the advances in early genetic testing of germline and somatic mutations involved in DNA repair, and the clinical development of targeted agents. In order to implement the best individual medical strategies, in this article, we present an algorithm of treatment options, including recently developed targeted agents, for primary and recurrent ovarian cancer patients in Belgium.