Chemotherapy for gynecologic malignancies

Platinum-based chemotherapy is still the cornerstone in the chemotherapeutic approach of ovarian cancer patients. Recent advances include the introduction of paclitaxel in first-line chemotherapy and the demonstrated importance of administering cisplatin intraperitoneally in patients with small-volume disease. DNA repair and apoptosis are increasingly recognized as important processes involved in resistance to chemotherapy. Tamoxifen use is associated with a higher risk of endometrial cancer, with duration and cumulative dose of tamoxifen as additional factors. Hormonal therapy continues to be an important component of treatment of patients with advanced or recurrent endometrial cancer. Combination chemotherapy induces higher response rates in such patients. However, any advantage towards an improved survival remains a controversial issue. Isotretinoin plus interferon alfa-2a for squamous cell carcinoma of the cervix is still a topic of interest. There is a great need for agents and interventions with more efficacy and more specificity for the biology of the different gynecologic malignancies.