Autologous Stem-Cell Transplantation in Ovarian Cancer: Is More Better?

• Hematopoietic stem cell transplantation
• Transplantation, autologous
• Ovarian neoplasms
• Disease-free survival
• Antineoplastic agents, combined

Although advanced-stage epithelial ovarian cancer is highly responsive to initial therapy, most patients ultimately succumb to the disease. According to a series of studies conducted by multi-institution cooperative groups, such as the Gynecologic Oncology Group, surgery to accomplish maximal cytoreduction followed by six cycles of carboplatin and paclitaxel, or cisplatin and paclitaxel, is the current standard of care (1-4). Better treatment is urgently needed to improve long-term disease-free survival for patients with ovarian cancer.

On the basis of extrapolation of data (1-4), it can be expected that approximately 80% of patients with ovarian cancer will at some point achieve complete clinical remission. However, disease will recur in approximately 40% of patients within 2 years and in another 20% within the next 2 to 5 years. Only approximately 20% of patients with ovarian cancer will have long-term disease-free survival.

Several general approaches have been developed in an attempt to increase the percentage of patients in whom disease can be permanently eradicated. Among these approaches are consolidation intraperitoneal chemotherapy (4, 5), consolidation systemic chemotherapy (4, 6), and autologous stem-cell transplantation, which is discussed by Stiff and colleagues (7) in this issue. Other factors that should …