scout

Maurie Markman, MD

Articles by Maurie Markman, MD

The question of a well-defined role for the use of neoadjuvant chemotherapy in the treatment of ovarian cancer is recognized to be one of the most hotly debated issues in the management of female pelvic malignancies.[1-3] One group of oncologists would argue that it should be the rare patient (eg, with severe comorbidity) who is not a candidate for an initial attempt at maximal cytoreduction.[1]

Over the past 2 decades, we have seen major progress in the management of women with ovarian cancer, with improvements in both overall survival and quality of life. To truly appreciate this progress, it is important to understand the state of affairs regarding the treatment of ovarian cancer in the early 1980s. This paper will discuss that historical background, describe the increasingly favorable impact of evolving treatment paradigms in ovarian cancer, and note future directions for clinical research in this complex disease process.

In this review, Dr. Garrison andher colleagues present a generaloverview of the development ofmyalgias and arthralgias associatedwith taxane chemotherapy. As notedby the authors, these side effects oftreatment can be quite distressing,although clearly not life-threatening.Fortunately, only a minority of patientsexperience such severe symptomsthat consideration needs to begiven to discontinuing treatment orsubstantially altering the planned taxanedose and schedule.

In their excellent summary of randomized trials examining the management of cancers of the uterus and ovary, Kim and coauthors highlight a significant and worrisome difference that has developed between the two gynecologic malignancies over the past decade, with regard to the direction of clinical research involving chemotherapy. Although it is recognized that cytotoxic chemotherapy is employed in the majority of women with ovarian cancer at initial diagnosis, whereas such treatment is fortunately only required in a minority of individuals with endometrial cancer, it is unclear why there has been such a major divergence in the drugs and combination regimens currently being evaluated in clinical trials.

Despite the activity of initial chemotherapy in ovarian cancer, the majority of women presenting with advanced disease will ultimately experience disease recurrence and be required to consider second-line, or salvage, chemotherapy options. The well-written, informative article by Sabbatini and Spriggs provides a fairly comprehensive overview of important factors to consider when determining the most appropriate treatment options in this clinical setting.

The paper by Schilder et al is an outstanding review of the current status of the management of women with early-stage ovarian cancer. As the paper makes clear, despite the efforts of numerous cancer research groups around the world, an optimal treatment strategy for early-stage ovarian cancer has yet to be defined.

Latest Updated Articles