Chemotherapy in epithelial ovarian cancer

The management of epithelial ovarian carcinoma can be the most challenging of all the gynecologic malignancies partly because of the paucity of effective screening tools for early-stage disease. Numerous randomized clinical trials identified several cytotoxic agents that are active against epithelial ovarian cancer, but the current standard of care remains optimal surgical cytoreduction followed by platinum and taxane-based chemotherapy. When disease recurs or progresses, alternative chemotherapy regimens often have efficacy, either as a single agent or in combination. While treatment recommendations should be individualized, the disease-free interval after induction chemotherapy is often the most clinically useful parameter to determine selection of second-line therapy. Investigations into novel chemotherapeutic agents and other biologic molecules have led to advances in the therapeutic armamentarium and have improved survival for women with ovarian cancer.