Treatment options in patients with recurrent ovarian cancer.
The majority of patients with advanced ovarian cancer need a second-line treatment for recurrent disease after surgical cytoreduction and first-line chemotherapy. In these patients, treatment planning is mainly dependent on the platinum-free-interval. The patients may be distinguished as platinum-refractory (progression under platinum-based therapy), platinum-resistant (relapse within 6 months), or platinum-sensitive (relapse after 6 months). Patients with platinum-refractory or -resistant disease should be encouraged to enter clinical trials. Alternatively, these patients could receive tamoxifen or a non-platinum single-agent therapy. Since response rate and duration to different single-agents are similar, patient convenience, toxicities from prior treatment, side-effects and costs play a role in the drug selection for salvage chemotherapy. Patients with platinum-sensitive disease should receive carboplatin based or carboplatin-plus paclitaxel-based regimens. Secondary surgical cytoreduction may have a role in highly selected patients with good performance status, with long disease-free interval and without extra-abdominal or liver metastases.
Gadducci
A
A
Department of Procreative Medicine, Pisa, Italy. a.gadducci@obgyn.med.unipi.it
Conte
P
P
Cianci
C
C
Negri
S
S
Genazzani
A R
AR
D005260:Female; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000601:surgery; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000601:surgery; D010166:Palliative Care; D016879:Salvage Therapy