Significant progress has been made in the management of advanced
ovarian cancer. Response rates to
platinum-based
chemotherapy are respectable; however, recurrence continues to be the rule rather than the exception.
Chemotherapy is administered as initial treatment and for disease recurrence, often over a period of many years--thus
ovarian cancer is considered a
chronic disease by many oncologists. The importance of the
taxanes in the treatment of
ovarian cancer is well established. However,
taxanes are associated with numerous toxicities, resulting in the need for alternative dosing strategies that produce fewer side effects, or the discovery of novel
taxanes with equivalent anti-
tumor activity, but a more favorable toxicity profile. Several
taxanes are in development including
CT-2103, a macromolecule consisting of
paclitaxel conjugated to a biodegradable, water-soluble
polymer of
glutamic acid. Clinical data of
CT-2103 as a single agent and in combination have demonstrated activity in previously treated
ovarian cancer patients, both in
platinum-sensitive and
platinum-resistant disease.
CT-2103 appears to be potentially associated with a more favorable toxicity profile relative to
paclitaxel, and enhanced solubility allows for a 10-minute infusion. Ongoing trials employing this agent will focus on extending survival, optimizing quality of life, and defining a possible role for
CT-2103 in the standard management of advanced
ovarian cancer.