The patient is currently undergoing the first cycle of chemotherapy with taxol, after surgery (it was not possible to remove all the metastases). Due to the aggressivity of this type of cancer, the prognosis cannot be optimistic.
Provisional Phase I (MD Anderson trial of temsirolimus plus bevacizumab) and Phase II (GOG trial at University of Colorado, of temsirolimus monotherapy) data, plus additional Phase I MD Anderson trial data of the triplet regimen of liposomal doxorubicin (Doxil), bevacizumab, and temsirolimus) suggest that the complex PI3k/AKT/mTOR pathway often shows significant deregulated in gynecologic cancers, and PI3k/AKT/mTOR inhibitors appear to limit both tumor proliferation and disease progression, especially in combination of mTOR inhibitors with other chemotherapeutics or biological therapies (especially anti-VEGF agents like bevacizumab), in various forms of endometrial and ovarian malignancies.
The most evidenced mTOR inhibitor deployed with favorable outcome in this domain of application is temsirolimus (Torisel), an inhibitor of the mTOR complex with, in addition, attractive potent HIF-1α inhibitory activity and this can be coupled either with the antiangiogenic / anti/VEGF agent bevacizumab (Avastin) or with a chemotherapeutic like liposomal doxorubicin (Doxil/Caelyx) (among many other choices), or both.
An alternative to clinical practice however would be a clinical trial, and here I would note to your attention the TEMSIROLIMUS AND BEVACIZUMAB IN TREATING PATIENTS WITH ADVANCED ENDOMETRIAL, OVARIAN, LIVER, CARCINOID, OR ISLET CELL CANCER TRIAL (NCT01010126):
http://clinicaltrials.gov/ct2/show/NCT01010126?term=NCT01010126&rank=1
should the patient be able to meet the eligibility requirements (which are relatively broad), being conducted in 64 locations across the States.
Dear Dr. Kaniklidis, I do thank you very much for your precious indications, which I will immediately check, hoping they could benefit my friend. Kindly forgive for reading so late your answer.
Best regards,
Jane
Jane:
Glad to help. Here are the links you need for the three trials I referred to:
Phase I MD Anderson: liposomal doxorubicin (Doxil), bevacizumab, and temsirolimus
https://clincancerres.aacrjournals.org/content/17/21/6840.full
Phase I MD Anderson Trial: temsirolimus plus bevacizumab
https://clincancerres.aacrjournals.org/content/18/20/5796.full
Phase II GOG Trial: temsirolimus monotherapy
http://www.sciencedirect.com/science/article/pii/S0090825811004896
Good luck.
Constantine
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