Consolidation therapy in ovarian cancer: where do we stand?

The goal of consolidation chemotherapy in ovarian cancer is to maximize the benefit of primary therapy and improve progression-free and overall survival. Consolidation has been tested with multiple treatment modalities including cytotoxic chemotherapy, radiation and biological therapies. A review of recently published clinical trials is presented.

Consolidation therapy is not a new concept. More than 30 clinical trials utilizing consolidation therapy have been published in the last two decades. The natural history of many patients who participate in consolidation trials is often favorable, making the effect of consolidation treatments difficult to interpret. Small phase II studies have suggested improved outcomes compared with historical controls, but randomized trials have yet to show a distinct survival advantage with consolidation therapy.

The role of consolidation therapy in ovarian cancer is evolving. Although it is recognized that ovarian cancer patients commonly suffer recurrences after initial response, it is not clear that current therapies alter this course. Future clinical designs should include appropriate control groups. Novel therapies should be studied in randomized controlled trials with sufficient power to detect relevant clinical differences, the most important being overall survival. Toxicity and ease of administration must be considered against the benefits of therapy.