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02 June 2021, Volume 37 Issue 6 Previous Issue    Next Issue

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Ovarian cancer and normalization of gene detection. GAO Qing-lei 2021, 37(6): 605-609.  DOI: 10.19538/j.fk2021060102 Abstract ( )   As the treatment for epithelial ovarian cancer moves into precision medicine，the importance of genetic testing to determine mutations in cancer susceptibility genes has grown. Test for germline BRCA1/2 mutations is routinely recommended in all women diagnosed with epithelial ovarian cancer，to identify hereditary epithelial ovarian cancer and inform patients' medical decisions and those of their relatives. Other cancer susceptibility genes，such as homologous recombination deficient（HRD）genes and mismatch repair（MMR）genes，are also associated with inherited risk of ovarian cancer，and numerous ongoing studies are investigating their utility in predicting therapeutic response. This paper will discuss how to conduct clinical practice in genetic testing for epithelial ovarian cancer，and hope to guide therapeutic options for patients’ individualized treatment.

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Primary and interval cytoreductive surgery for ovarian cancer. HUANG He，FENG Yan-ling，LIU Ji-hong 2021, 37(6): 609-613.  DOI: 10.19538/j.fk2021060103 Abstract ( )   The rate of NACT use has increased annually for advanced ovarian cancer in clinical practice. Neoadjuvant chemotherapy（NACT）for ovarian cancer is still controversial for many years，although patients received NACT followed by interval cytoreductive surgery had equivalent progression-free survival and overall survival compared with primary cytoreductive surgery among women with advanced stage ovarian cancer, with less surgical morbidity in randomized control studies.At present，the newly diagnosed ovarian cancer patients should be evaluated by gynecological oncologists and/or multi-disciplinary assessment if necessary.Primary tumor reductive surgery should be attempted priority to achieve satisfactory tumor resection after evaluation.However，neoadjuvant chemotherapy followed by interval tumor reductive surgery is an alternative approach for unresectable tumor or reductive surgery is not feasible.

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First-line chemotherapy for newly diagnosed epithelial ovarian cancer. DOU Sha，LI Yi，CUI Heng 2021, 37(6): 613-616.  DOI: 10.19538/j.fk2021060104 Abstract ( )   The initial treatments for epithelial ovarian cancer include cytoreductive surgery，platinum-based chemotherapy and maintenance therapy. In this article，we present the evolution and standardized application of first-line chemotherapy for newly diagnosed epithelial ovarian cancer. The regimen of paclitaxel followed by carboplatin every three weeks is still the preferred regimen for newly diagnosed epithelial ovarian cancer and its outstanding status has never been replaced. In this article，we also review the indications for bevacizumab and other recommended regimens for newly diagnosed epithelial ovarian cancer. At the end，we point out the problems of non-standardized chemotherapy in clinical practice and stress the importance of standard chemotherapy in order to help increase the survival rate of patients with advanced epithelial ovarian cancer.

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Problems related to surgery for platinum-sensitive relapsed ovarian cancer and standardized diagnosis and treatment. CHEN Yu-lian，SHI Ting-yan，ZANG Rong-yu 2021, 37(6): 616-620.  DOI: 10.19538/j.fk2021060105 Abstract ( )   The standards of care for relapsed ovarian cancer are not well determined. Given the results of three parallel randomized clinical trials（SOC-1，DESKTOP 3，and GOG-0213）on the efficacy of secondary cytoreductive surgery，patients with relapsed ovarian cancer who have received one previous therapy should be counselled about the options of secondary cytoreduction in specialized centers with high volumes of ovarian cancer surgery. An ideal patient selection algorithm should be implemented to filter right candidates. Meanwhile，an inappropriate decision on surgery could be detrimental. An individual therapy should be clearly indicated for each of patients. Secondary cytoreductive surgery is just a part of systemic therapies for ovarian cancer，and state of the art therapy for relapse comes from standard of care of the first-line therapy. In china，it’s a long way.

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Application and controversy of minimally invasive surgery in the treatment of ovarian cancer. DENG Li，LIANG Zhi-qing 2021, 37(6): 620-623.  DOI: 10.19538/j.fk2021060106 Abstract ( )   The surgical treatment for ovarian cancer is very important. It has been a hot topic to correctly evaluate the effect of operation mode and operation path on survival benefit of patients. Minimally invasive technique has been applied in the stage operation of early ovarian cancer，the reduction of advanced ovarian cancer and the reduction of recurrent ovarian cancer. With the continuous development of minimally invasive technology，robot surgery and single hole surgery and so on have been involved in the surgical treatment for ovarian cancer. This paper includes the latest literature meta-analysis results and clinical research results，and summarizes the application and controversy of minimally invasive surgery in the treatment of ovarian cancer. We also look forward to more and more high-quality clinical research to evaluate various surgical methods and guide clinical practice.

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Problems related to bilateral salpingo-oophorectomy for hereditary ovarian cancer and the controversy. YUAN Zeng，SONG Kun，KONG Bei-hua 2021, 37(6): 623-627.  DOI: 10.19538/j.fk2021060107 Abstract ( )   Ovarian cancer is the leading cause of gynecologic cancer death in the world，and there is clear evidence that some ovarian cancers have a high genetic risk. It is recommended to radicalize management，using risk-reducing bilateral salpingo-oophorectomy in hereditary ovarian cancer. This topic will discuss some topics related to risk-reducing bilateral salpingo-oophorectomy in hereditary ovarian cancer population.

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Complications of cytoreductive surgery for ovarian cancer and the prevention and treatment.  MENG Yuan-guang，YE Ming-xia 2021, 37(6): 627-630.  DOI: 10.19538/j.fk2021060108 Abstract ( )   Ovarian cancer is one of the most serious malignancies of female reproductive system. Satisfactory cytoreductive surgery can improve the prognosis of patients. However，this kind of surgery involves a wide area and many organs. The management of perioperative complications is a difficult problem. Base on the literatures at home and abroad as well as the treatment experience，this review discussed the types，causes and prevention and treatment strategies of perioperative complications so as to provide experience for reducing the incidence of complications and improving the management ability of complications.

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Current status and progress of immunotherapy for ovarian cancer. JIANG Fang，XIANG Yang 2021, 37(6): 630-634.  DOI: 10.19538/j.fk2021060109 Abstract ( )   Ovarian cancer is one of the most lethal gynecological malignancies.Traditional treatment methods include surgery and chemotherapy，but 70% of EOC patients have disease recurrence after initial treatment. In the past two decades，immunotherapy has developed rapidly and has revolutionized the treatment for various types of cancers. Although immunotherapy response rates among ovarian cancer patients remain modest，treatment with immune checkpoint inhibitors，therapeutic tumor vaccines，and adoptive cellular immunotherapy are developing rapidly. At the same time，different combination treatment strategies are also being studied and explored. The challenge remains to be identifying predictive indicators for immunotherapy and determining what treatment combinations are most suitable for this disease. This article reviews the most promising immunotherapies for EOC，hoping to improve the treatment effects on EOC with the continuous development of technology.

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Standardization of targeted therapy for ovarian cancer. WANG Deng-feng，ZHANG Guo-nan 2021, 37(6): 634-639.  DOI: 10.19538/j.fk2021060110 Abstract ( )   In recent years，targeted therapy has made great progress in the field of ovarian cancer，which has changed the treatment model of ovarian cancer. Bevacizumab has a definite effect in the initial treatment and maintenance treatment of high-risk advanced ovarian cancer，and in the treatment of platinum-sensitive recurrent ovarian cancer and platinum-resistant recurrent ovarian cancer. It can be combined with chemotherapy or used alone. Poly ADP-ribose polymerase（PARP）inhibitor is currently the most important type of drugs in targeted therapy for ovarian cancer. It exerts an anti-tumor effect through a "synthetic lethal" effect，which significantly improves the prognosis of patients with ovarian cancer. PARP inhibitor has been recommended as the standard treatment to be used in the maintenance treatment of platinum-sensitive recurrent ovarian cancer and first-line maintenance treatment for newly-treated advanced ovarian cancer. We should strictly grasp the indications of targeted therapy and pay attention to the standard management of the whole process，including pre-treatment evaluation，monitoring during and after treatment and timely management of adverse events，so as to reduce the occurrence of related adverse events and increase the safety of long-term treatment. At the same time，it can also improve the patients' medication compliance，which is also the basis for ensuring the efficacy.