Epithelial Ovarian Cancer Sample Clauses

Epithelial Ovarian Cancer. Ovarian cancer is a lethal disease with 22,530 new cases and 13,980 deaths expected in 2019 in the US (SEER Cancer Statistics Factsheet 2019). The estimated number of new EOC cases in the EU (EU27) in 2012 was 44,149 with 29,758 deaths (EUCAN Cancer Fact Sheet: Ovary 2019). The overall 5-year survival for EOC patients is only 44% (Xxxxxxxxx 2004, Xxxxxxx 2012). Recent studies indicate that ovarian, peritoneal, and fallopian tube cancers are not distinct entities, but represent a spectrum of diagnoses that originate in the Mullerian tissue. Primary fallopian tube carcinoma and peritoneal cancers are now included in the ovarian cancer staging classification (Xxxx 2015, Xxxxx 2010, Xxxxxxx 2011, O’Shannessy 2013), and are considered to be part of EOC with the same treatment and outcomes. Despite considerable improvements in primary therapy, 80% of the patients with advanced EOC are expected to relapse during or after treatment with platinum-containing regimens (Xxxxxxxxx 2019). Disease recurring within 6 months of platinum-based chemotherapy is classified as platinum resistant, whereas, disease recurring longer than 6 months after therapy is termed platinum sensitive. While PARP inhibitors (eg, olaparib and rucaparib) were initially approved as single-agent treatment for EOC patients with BRCA mutations (~15% of EOC) who received ≥ 2 prior regimens (Xxxxx 2019), their greatest benefit appears to be as maintenance therapy, both in the recurrent platinum-sensitive (Xxxxx 2016) and front-line settings (Xxxxxxxx-Xxxxxx 2019, Xxxxx 2018), with the greatest treatment effect in patients with BRCA mutations or other mechanisms of homologous recombination deficiency. Like PARP inhibitors, bevacizumab is also approved for EOC in combination with chemotherapy and as continued monotherapy in the maintenance setting. While bevacizumab is approved in combination with chemotherapy in the platinum-resistant setting, many patients receive it earlier in their disease course based on the approvals in the front-line and recurrent platinum-sensitive settings. For those who do receive it in the platinum-resistant setting, bevacizumab combinations are limited to patients who have received no more than 2 prior chemotherapy regimens and are not at risk for bowel perforations (recto-sigmoid involvement, bowel involvement and/or history of bowel obstruction) (Xxxxxxxxxx 2012, Pujade-Xxxxxxxx 2014). Those patients with PROC who have received prior bevacizumab, either in the platinum-res...
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