Recurrent ovarian cancer.

Ovarian cancer is the most common cause of death from gynecologic malignancies in the United States. Although ovarian cancer is very responsive to multiple chemotherapeutic agents, with objective response rates of up to 80% with the standard platinum and taxane doublets, 75% of patients relapse within 2 years of primary therapy and become candidates for treatment of recurrent disease. Recurrent ovarian cancer is increasingly approached as a chronic disease that requires sequential therapy with available agents. Several issues remain controversial regarding the treatment of patients with recurrent ovarian cancer, including the timing of salvage therapy, choice of agents, and use of monotherapy versus combination regimens. Also, the role of the CA125 tumor marker in detection of recurrence and assessing response to therapy remains unresolved. In this article we address these issues with an emphasis on evidence from the available literature and also discuss the clinical trials that are currently underway to resolve these issues.