Rationale for maintenance or consolidation therapy in ovarian cancer

Despite the high objective response rare of advanced ovarian cancer to platinum-based chemotherapy, relapse is common and most patients ultimately experience disease progression. These data lead to the hypothesis that extending treatment beyond the standard 6 cycles may improve both progression-free and overall survival in a patient population demonstrated to have exhibited major inherent chemosensitivity to the primary chemotherapy program. A preliminary analysis of a randomized phase III trial conducted by the Southwest Oncology Group and the Gynecologic Oncology Group has revealed that 12 monthly cycles of single-agent paclitaxel delivered to patients with advanced ovarian cancer who have attained a clinically defined complete response to initial platinum/paclitaxel chemotherapy results in a highly statistically significant reduction in the risk of recurrence. This proof of principle study should lead to further investigation in defining an optimal maintenance or consolidation strategy for the treatment of women with advanced ovarian cancer.