Optimum chemotherapy for ovarian cancer.

A series of prospective randomized trials recently have defined the new standard of care for chemotherapy patients with ovarian cancer. The current preferred regimen consists of carboplatin (dosed to an area-under-the-curve [AUC] of 5.0-7.5) plus paclitaxel (175 mg/m2-3 h infusion). This is an outpatient regimen that does not require growth factor support and six cycles are administered on a 21-day schedule. There is no evidence that any type of additional therapy impacts upon survival, including additional cycles of the same chemotherapy or switching to an alternative intravenous chemotherapy, high-dose chemotherapy with hematologic support, intraperitoneal chemotherapy, or whole abdominal radiation. The majority of patients will achieve a clinical complete remission with the regimen although the relapse rate remains high. Current trials are exploring new schedules of drug delivery as well as new combinations which include new agents such as gemcitabine and topotecan.