What are the treatment recommendations for platinum-resistant recurrent ovarian cancer?

Updated: Dec 06, 2018
  • Author: Shannon M Grabosch, MD; Chief Editor: from Memorial Sloan-Kettering - Yukio Sonoda, MD  more...
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Answer

Answer

If recurrence occurs less than 6 months after initial or subsequent complete clinical response to platinum-containing chemotherapy, the patient should be treated with one of the regimens below. There is no standard for the number of cycles of treatment given in this situation. Often treatment is changed because of progressive disease or toxicity.

Although liposomal doxorubicin is a good first choice, many other agents with similar efficacy are available; the final choice depends on individual circumstance and patient and physician preference. Some of the choices include the following:

Alternatively, consideration may be given to bevacizumab as a single agent or in combination, as follows:

  • Bevacizumab 10 mg/kg IV every 14 d in combination with one of the following IV chemotherapy regimens: paclitaxel, pegylated liposomal doxorubicin, or topotecan (topotecan is given weekly) [43]  or

  • Bevacizumab 15 mg/kg IV every 21 d in combination with topotecan (every 21 d) [43] or

  • Bevacizumab 15 mg/kg IV (initially over 90 min, then over 60 min, and finally over 30 min for subsequent infusions); every 21 d until progression [29, 44] or

  • Bevacizumab 10 mg/kg IV on days 1 and 15 plus  topotecan 4 mg/m2 IV on Days 1, 8, and 15, every 28 days [45]


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