Treatment of Recurrent Epithelial Ovarian Cancer: Platinum-Resistant Disease
Platinum-resistant recurrent epithelial ovarian cancer represents a specific clinical situation with distinct management considerations. The approach differs substantially from platinum-sensitive recurrence and depends on the pattern of prior treatment response.
Clinical Scenario
This protocol applies to recurrent epithelial ovarian cancer meeting any of the following platinum-resistance criteria:
- Progression on primary, maintenance, or recurrence therapy
- Stable or persistent disease while not on maintenance therapy
- Complete remission followed by relapse within 6 months of completing chemotherapy
Treatment Approach (Overview)
In the platinum-resistant setting, non-platinum cytotoxic regimens are generally preferred over re-challenge with platinum-based therapy. Certain regimens may be combined with a targeted anti-angiogenic agent, depending on clinical circumstances and contraindication profile. For tumors expressing a specific cell-surface receptor at sufficient levels, a targeted antibody-based therapy represents a preferred single-agent option. Best supportive care is provided alongside systemic treatment.
Full regimen options, eligibility criteria, sequencing guidance, and contraindication details are available in the complete structured protocol.
References
- Platinum-resistant disease: Progression on primary, maintenance or recurrence therapy
- Complete remission and relapse <6 mo after completing chemotherapy
- Albumin-bound Paclitaxel/Relacorilant
- Docetaxel
- Gemcitabine
- Liposomal Doxorubicin
- Liposomal Doxorubicin + Bevacizumab
- Paclitaxel (Weekly)
- Paclitaxel (Weekly) + Bevacizumab
- Oral Cyclophosphamide + Bevacizumab
- Topotecan
- Topotecan + Bevacizumab
- Mirvetuximab soravtansine-gynx (for FRα-expressing tumors [≥75% positive tumor cells])(category 1)
- Steroid premedication should not be used.
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