Maintenance or consolidation therapy in advanced ovarian cancer

Most patients with advanced epithelial ovarian cancer (EOC) achieve a clinical complete response (CR) or have no clinical evidence of disease after aggressive cytoreductive surgery and 6 cycles of platinum-/taxane-based chemotherapy. From the reported randomized trials using different durations or different cycles of chemotherapy, none of these showed improvement in survival beyond 6 cycles. Data from the literature do not support a relationship between the number of cycles and response or between the cumulative dose and response. In addition, no benefit in survival was detected with high-dose and intensity chemotherapy administered for a short time compared with standard-dose chemotherapy given for a longer time. However, statistically significant differences in progression-free survival were found in patients who achieved a clinically defined CR to a platinum (CDDP)-/paclitaxel-based chemotherapy and who continued single-agent paclitaxel for an extended time period. Notably, this randomized trial most likely did not offer any survival advantage, as it was closed prematurely by the Data Safety Monitoring Committee in accordance with the guidelines planned for interim analysis of primary end-points.