Antineoplastic agents in the management of ovarian cancer: current status and emerging therapeutic strategies.

The intent of this review is to critically examine the status of the current chemotherapeutic management of ovarian cancer and possible future directions. Standard systemic chemotherapy includes a platinum agent (cisplatin or carboplatin) and a taxane (paclitaxel or docetaxel), a strategy that has not changed in more than a decade. Phase-III-trial data have revealed the superior efficacy of intraperitoneal cisplatin, compared with systemic platinum delivery, in small-volume residual advanced ovarian cancer, but in general this approach is associated with greater toxicity. Several regimens have been shown to be active in recurrent and platinum-resistant ovarian cancer, but an optimal management strategy has not been defined. Although 'targeted therapeutic approaches' are currently being explored in this disease, with the important exception of anti-angiogeneic agents, to date, limited biological and clinical activity have been demonstrated.