Second line chemotherapy for relapsed ovarian canser

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1.Experimental Chemotherapy : Sequential therapy with carboplatin, paclitaxel, and CPT-11 was performed for rat primary ovarian cancer. No macroscopic differences.in anti-tumor effects were observed, suggesting limitations of this sequential therapy in treatment of clinical cases, although some issues, such as selection of adequate doses, remain to be further investigated.2.Jnhibitory effect of an anti-vascularization inhibitor on tumor viability : Although an anti-vascularization inhibitor (FNP-470)was administered to rat neonates 7 days after intraperitoneal administration of DMBA-OC-1 (cell line), tumor viability did not differ between the control group (25/31, 80.6%) and the TNP-470-treated group (26/36, 72.2 %). The number of new blood vessels was identical between the two groups at microangiography. This experimental model was thought to correspond to clinical micro-residual cases. However, use of some concomitant drug(s) with TNP-470 seemd to be required, because it was suggested that TNP-470 bad difficulty in inhibiting vascularization when used, alone.3.Clinical Study : The response rate of CPT-11/CDDP was 40% (33% for patients with resistant disease). Activity of topoisomerase-1 significantly increased in the responding cases, compared with the non-responding cases, indicating a possibility that treatment can be performed using this activity as a target. Paclitaxel showed low toxicity and effectiveness when administered weekly (sensitive : 3/4, resistant : 1/6).. No responding cases with resistant disease were observed in the treatment with dcetaxel/CPT-11.Four often cases with sensitive disease (40%) responded to docetaxel/carboplatin. In 11 of 24 frozen-stored clinical specimens (45.8%), p53 mutation was detected. Thus this mutation has been continuously studied at the present time, in relation tq clinical efficacy. Because all. 24 cases examined were negative for c-erbB-2, indications of herceptin were thought to be very limited.