New use of old medicine || The role of lysole in the treatment of advanced ovarian cancer

At present, there is no treatment specification for ovarian cancer using lysole.
, we systematically review and analyze the literature on the use of lysophotocin in ovarian cancer.
data show that lysoles play a role in both primary and relapsed ovarian cancer.
In low-level ovarian cancer, oleoplasm shows good results, especially when maintaining treatment, which seems to ensure an extended recurrence period, and in relapsed ovarian cancer, it can also extend the control period of the disease.
, however, the choice of the best treatment option and the identification of biologically relevant groups need to be determined in larger clinical trials.
worldwide, there are about 295,400 new cases of ovarian cancer each year, of which 184,800 die each year from the disease.
understanding the biological characteristics of endothy ovarian cancer, whether it is to develop a first-line treatment plan for first-time ovarian cancer patients, or to individualized treatment programs for patients with relapsed ovarian cancer, are important steps.
Although PARP (polyADP icingase) inhibitors and anti-angiogenesis therapies have broadened the treatment for ovarian cancer, the demand for new targeted drugs continues to grow.
especially for subsectives that are less common in histology, such as lowly differentiated ovarian cancer, targeted drugs are particularly important because we need to improve not only clinical outcomes, but also quality of life.
ovarian cancer has estrogen-like expression, the expression rate is about 25%-60%.
Endocrine therapy can be routinely recommended for the maintenance of estrogen-positive diseases, and hormone therapy options have been recommended as an effective option for patients with ovarian cancer.
is a nonsteroidal aromatase type II inhibitor that inhibits estrogen signaling path path.
its key mechanism is reversible competition to suppress aromatic enzymes, thereby preventing testosterone from converting to 17-β-esodiol (E2) without affecting levels of other steroids.
in vitro and in vivo models, as well as clinical studies, have shown the efficacy of estrogen blocking therapy in ovarian cancer.
For example, in 2D and 3D cultures with ER-plus ovarian cancer cell line, nonsteroidal aromatase inhibitors can inhibit growth in dose-dependent ways, indicating that estrogen ligens (ER) play a key role in the proliferation of ovarian cancer cells.
second, in the heterogeneous transfer model of ovarian cancer cells, the application of 4-hydroxy-nonsteroidal aromatase inhibitors led to tumor growth inhibition in most ER-ovarian cancers.
, in the heterogeneity transplant model of in vivo therapy, the survival rate of the animals was improved.
, these subclinical and clinical studies support the use of hormone therapy in ovarian cancer.
present, aromatase inhibitors such as lactase can be used as an alternative treatment for the recurrence of ovarian cancer, mainly to extend the start time of the next treatment.
given the lack of definitive evidence for prospective trials, this paper is used to assess the role of cytospherics in the treatment of ovarian cancer.
we summarize the clinical efficacy of this targeted drug in primary and relapsed ovarian cancer, and highlight potential strategies to enhance the drug response of ovarian cancer.
Method: The following keywords and their different combinations are used in the PubMed and Cochrane databases to search for the role of phosphonate in ovarian cancer: "phosphonate," "estrogen-like," "endocrine therapy," "aromatase inhibitors," "ovaries," "cancer," "cancer," "advanced," "low-level," "slurry."
developed a detailed search strategy to identify key studies that fit the topic.
literature search is limited to English-language publications for human studies.
study must meet the following criteria for this review: (1) a report on the effectiveness of the treatment of ovarian cancer patients with low-level and/or high-level slurry;
the role of phosphons in other primary tumors and precancer lesions was excluded.
This is also included when abstracts of international conferences (European Society of Oncology, European Society of Radiotherapy and Only Oncology, American Society of Radio oncology and American Society of Clinical Oncology) contain information that the authors of our study believe are useful for statistical analysis.
search ends in October 2019.
electronic search identified 4,373 citations, which were reviewed for further evaluation after screening and excluded from the four citations because they did not meet the inclusion criteria (figure 1).
were grouped according to the subject in the study and possible histological entities (low- and high-level slurry ovarian cancer).
because the data analysis methods are different, so the quality of the data is higher than the quantitative.
chose a total of 17 manuscripts.
based on the Preferred Reporting Project (PRISMA) guidelines for systematic evaluation and meta-analysis.
figure 1 includes the results of the selection process of the study for the initial treatment of low-grade slurry ovarian cancer, which can be used as an auxiliary treatment for standard programs for patients with low-grade slurry ovarian cancer.
two major retrospective studies documented the clinical benefits of receiving lysole maintenance therapy after standard treatment (primary surgery and complementary chemotherapy) for women who were first diagnosed with stage II-IV low-grade slurry ovarian cancer.
Gershenson et al. evaluated the clinical outcomes associated with hormone maintenance therapy and compared them with routine observations after initial tumor reduction surgery and platinum-based chemotherapy.
included a total of 203 patients (observation group n=133; hormone maintenance therapy group n=70).
in the hormone maintenance group, the majority of patients (n-38;54%) received the treatment of indentation.
results showed that the medium progression-free survival of patients receiving the maintenance treatment of lycopene after routine treatment was significantly higher than that of patients with conventional observation (64.9 months to 26.4 months; p.lt;0.001).
the benefit was not related to residual disease after the completion of the initial chemotherapy.
the risk of progression decreased significantly in patients receiving hormone maintenance therapy (HR:0.44, 95% CI 0.31 to 0.64; p.lt;0.001) compared to women under observation, but there was no statistically significant difference in overall survival rates between the two groups (115.7 vs102.7 months).
in this study, 76 (37%) of the 203 patients had information about ER expression and only 3 were ER-negative.
in all subgroup analyses (ER,PR-plus, and PR-patients), the efficacy of the maintenance group was better than that of the observation group.
these studies did not indicate which patients benefited more from hormone maintenance therapy.
because only 3 out of 76 patients with available data are ER-, it is not possible to make meaningful comparisons.
retrospective study published by Fader et al. analyzed the efficacy of hormone maintenance therapy in patients with stage II-IV low-grade slurry ovarian cancer.
27 patients were treated with cell reduction and monosterone.
55.5% of patients took lysole.
41 months after the middle follow-up, 6 patients (22.2%) relapsed and 2 patients (7.4%) died.
analysis, neither the mid-progressed lifetime and the total lifetime were reached.
three-year progress-free survival rate was 79 per cent and the three-year total survival rate was 92.6 per cent.
study, 96 percent of tumors expressed ER, while only 32 percent of tumors expressed PR.
Finally, in the recently presented Phase II/III study, patients with low-grade slurry ovarian cancer were randomly treated with quercetinine (MEK inhibitors) or one of five standard treatment options, including fir alcohol peritherapy, polyglycol lipid amycin, topotin, phosphonate, or tymoxifen.
final data showed that Qumentiniry significantly improved progress-free survival and mitigation rates.
, however, compared to standard chemotherapy, the overall remission rate (full and partial) was 13% and the disease stabilization was 70%.
high-level slurry ovarian cancer has recently been tested in high-level slurry ovarian cancer as a means of maintenance therapy.
a retrospective analysis included a total of 50 patients with FIGOIII-IV high-level slurry ovarian cancer, with 23 patients receiving lysole therapy (group A) after standard treatment and 27 patients receiving no maintenance therapy (group B).
1% of all patients with ER-≥ cancer.
two groups of disease stage comparisons (60% FIGO III and 40% FIGO IV in Group A, 75% FIGO III and 25% FIGO IV stages in Group B) and the rate of residual disease (R0 is 58%) were comparable.
the use of phosphor is associated with a significant increase in recurrence-free intervals, and this benefit is independent of the time at which indentation is started.
the same effect in residual high-risk patients with bevadant anti-maintenance therapy.
20% of patients who simply applied bevadan did not relapse after 12 months, compared with 87.5% of patients who took lysolone at the same time who did not relapse after 12 months, with no recurrence interval of 8.8 months vs. 21.6 months (p= 0.026).
Expert Opinion: Given the nature of its retrospective studies, these data should be viewed with caution; however, although the level of evidence of survival benefits from the application of querphine to sustain continuous treatment after initial surgery and chemotherapy is low, there is consensus that this intervention applies to the initial treatment of low-level slurry ovarian cancer.
encourage forward-looking research.
current recommendations are listed in Table 1.
table 1 currently recommends guidancelinesSettingLevels for evidencegrades of recommendationSettingLevels for ovarian cancer (with an oral dose of 2.5 mg/day): based on lower-level evidence, NCC is considered appropriate for intervention.
IV: retrospective queue studies or case-controlled studies;
ESMO-ESGO, European Society of Medical Oncology - European Society of Gynaecological Oncology;
ongoing trials are currently under way in two Phase III clinical trials of the application of cytocytocinoma, one "full-time" and the other a low-level slurry-liquid ovarian cancer-specific trial.
Phase III Prospective Study called MATAO (NCT04111978) was designed to assess the efficacy of standard post-chemotherapy after initial diagnosis of ER-plus endo-ovarian cancer (high or low level).
this is an advantageous clinical trial, the hypothesis is that the treatment of oleosis can increase progress-free survival compared to standard treatment.
540 patients will be assigned to the test group (phosphor) or control group (placebo) on a 1:1 scale.
take 2.5 mg of lycra and placebo comparison once a day for 5 years until toxic symptoms or underlying disease progression occurs.
another Phase III prospective trial (NCT04095364) tested the effects of cratin in the treatment of patients with stage II-IV low-grade slurry ovarian cancer in the form of a combined yew alcohol and carpentry.
this is a non-shoddy test, the main endpoint is no progress survival.
A total of 450 patients will be randomly assigned to: Group I (six cycles of yew alcohol plus carabenium, followed by treatment once a day for phosphorus until the disease progresses or there is unacceptable toxicity) and Group II (to quercetin once a day until the disease progresses or there is unacceptable toxicity).
Table 2 Tortocin in Relapse Ovarian Cancer Phase II Clinical Trials Table 3 Tortocin in Ovarian Cancer Ongoing Trial Clinical Trials.gov ID Study Design Phase Tumor Type Major Outcomes StatusNCT03936270 (D) 27) Pabohini-Phosphase II Ovarian Cancer 12 weeks PFS has not yet recruited NCT04111978 (10) to curvature vs placebo Phase III ovaries/periducts (fallopian tubes) Cancer PFS has not yet recruited NCT03673124 (28) placebo and incision Phase II low-grade slurry ovarian cancer/PFS is recruiting peritoneal/fallopian tube cancer NCT033782 97 (29) Acetyl saliolic acid, a biological marker of Early phase ovarian cancer is being recruited for metformin, Olapani, and I changes to acrylic NCT04095364 (11) carpentry, Yew alcohol, Phase II ovarian cancer PFS is being recruited and is currently being treated for relapse recurrence, Invasive cytospheric can be used in the treatment of relapsed ovarian cancer.
results of these results have been confirmed in a number of Phase II prospective clinical trials.
table 2 lists the details.
most of the trials targeted patients who were adequately pre-treated and did not select hormone receptor expression.
dose is 2.5 mg per day until the disease progresses.
, the results showed that lysole had clinical efficacy and minimal side effects in the treatment of relapsed ovarian cancer.
about 30 percent of patients showed disease stability, and objective remission rates included complete remission and partial remission of about 15 percent.
common side effects of indentation include nausea, fatigue, indigestion, headache and hot water.
the largest trial in the study recruited 60 patients with relapsed ovarian cancer, all of whom had different ER levels and histological characteristics.
the anti-tumor effect of phosphorescies was lower than expected and there was no evidence of complete mitigation.