How long should first-line chemotherapy continue?

Documentation for the optimal duration of first-line chemotherapy in advanced ovarian cancer is limited. Three randomised trials have compared 5-6 cycles with 8, 10 and 12 cycles respectively. None of the studies showed benefit of chemotherapy beyond 6 cycles. At the moment the standard number of cycles therefore must be 6 cycles. However, these data are based on platinum poly-chemotherapy regimens without taxanes. It may be that the optimal number of cycles is different when using taxanes regimens. It is not possible to tell from the literature if there is a relationship between the number of cycles and response or between the cumulative dose and response. At the moment no trial has shown any benefit of high-dose intensity chemotherapy administered over a short time compared with standard dose chemotherapy administered over a longer period.