晚期卵巢癌維持性治療的演進及近況

Maintenance therapy in advanced ovarian cancer

晚期卵巢癌容易復發，所以維持性治療具有重要的角色。過去的維持性治療以化學治療藥物為主，文獻上雖然有不錯的效果但因副作用明顯，臨床上並未被廣泛地使用。自從標靶藥物的問世及後續的臨床試驗結果證實，於晚期的卵巢癌使用注射或口服的標靶藥物，可以有效的延緩疾病復發的時間。PARP抑制劑使用於具有特定基因（BRCA1, BRCA2）突變或同源重組修復缺失的患者，可以顯著的增加病人的整體存活期（Overall survival, OS）。

Maintenance therapy plays an important role in advanced ovarian cancer due to high risk for recurrence. According to the literature, maintenance therapy with chemotherapy had significant improvement in PFS (progression free survival) but no significant benefit in OS (overall survival). Moreover, the adverse effects were hard to tolerate for patients to have long-term use. Targeted therapy like antiangiogenic agent and PARP inhibitors represents an important development in maintenance therapy. It has been confirmed that the use of PARP inhibitors in advanced ovarian cancer showed significantly longer progression free survival and overall survival for patients with BRCA1/2 mutations and/or homologous recombination deficiency.