![]() However, this is difficult to implement in daily practice because of problems with cost and sample quality assurance. Thus, gene expression analysis may be useful to select patients who would benefit from bevacizumab or ddTC. On the other hand, we previously showed that the mesenchymal type is more sensitive to taxane and ddTC may be useful for patients with this subtype. The Cancer Genome Atlas (TCGA) data analysis revealed that HGSOC can be classified into 4 gene expression subtypes : mesenchymal, proliferative, immunoreactive, and differentiated, and the efficacy of bevacizumab was reported to be higher in the first 2. However, subsequent clinical trials did not prove the benefit of ddTC. ![]() The Japanese Gynecologic Oncology Group (JGOG) 3016 study showed that ddTC therapy prolonged PFS and overall survival compared with TC therapy. Another option in chemotherapy regimens for ovarian cancer is dose-dense (dd) paclitaxel and carboplatin (TC), which increases the dose of paclitaxel. However, several phase III trials showed that bevacizumab only extends the median progression-free survival (PFS) by 3.8 months or 1.5 months. ![]() Besides, maintenance therapy with bevacizumab, an anti-vascular endothelial growth factor (VEGF) antibody, is another option. Hallmarks of HGSOC are mainly BRCA1/2 mutations and homologous recombination deficiency (HRD) and maintenance treatment with poly ADP-ribose polymerase (PARP) inhibitor is also used, after first-line chemotherapy. High-grade serous ovarian cancer (HGSOC) is the most common histopathological type of ovarian cancer. Ovarian cancer has the poorest prognosis among all gynecologic malignancies with an overall 5-years survival rate of approximately 50%.
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