Interpretation of the drug regimen for ovarian cancer of NCCN in the United States

There are many drugs available for ovarian cancer, just as the NCCN guidelines in the United States are updated, according to the guidelines, the drug regimen for ovarian cancer is systematically summarized As shown in the above table, it is the summary of the treatment of advanced ovarian cancer in the guide The relevant important places are marked in red In the plan given in the guide, there are chemotherapy plans in addition to targeted drugs, because chemotherapy is used more in China Here we focus on targeted drug therapy There are four drugs in the guide, bevacizumab, nilapani, olapani and lukapani Bevacizumab has been on the market in China Its commodity name is Avastin, and it has been covered by medical insurance in most parts of the country However, for bevacizumab, the guideline clearly states in the mark m below that if the patient has the risk of gastric perforation, bevacizumab is forbidden, which is expected to be known to the patient and family members Lukapani has no generic drugs at present Olapani and nilapani both have generic drugs These two drugs have been introduced in previous articles The advantage of nilapani is that it has an effect on whether or not there is BRCA mutation in patients In the label o of the guide, it also writes that in addition to the patients with BRCA mutation, it has an effect on the patients with genomic instability and six months of continuous progress after platinum chemotherapy It can be used These regimens are not the first choice, that is to say, they should be used after the first choice There are two targeted therapies: nilapanib and bevacizumab The other is pazopanil, which is also introduced in previous articles It is the first-line drug for renal cancer and soft tissue sarcoma The recommended level of ovarian cancer is a little low, only 2B Endocrine therapy Letrozole, anastrozole, exemestane, megestrol, leuprorelin and tamoxifen are also common Endocrine therapy is one of the standard treatment schemes for breast cancer Considering that ovarian cancer has a great relationship with estrogen, the guideline gives an endocrine therapy scheme which is also another treatment idea, which is very valuable If the patient is a low-grade serous cancer, trimetinib and fluvectin group can be considered If the patient has ntrk gene fusion mutation, then entetinib or rarotinib can be considered Among them, the generic rarotinib has been put on the market If the patient has MSI-H / dmmr, immunotherapy can also be considered The guideline recommends pabolizumab.