Emerging therapeutic options for platinum-sensitive ovarian cancer patients

Ovarian cancer is a relatively infrequent malignancy, but it is the fifth leading cause of cancer-related mortality in American women. The initial diagnosis of ovarian cancer is usually made when the disease is at an advanced stage. Although advanced ovarian cancer is characteristically sensitive to initial surgical debulking followed by platinum-based combination chemotherapy, it is rarely cured, and even patients who achieve a complete remission ultimately go on to experience relapsed disease. When tumor relapse occurs more than 6 months following completion of the platinum-based treatment, patients are defined as having platinum-sensitive disease. This roundtable includes an expert discussion of the options for treatment of patients with platinum-sensitive ovarian cancer. After distinguishing this form of recurrent ovarian cancer from platinum-resistant and platinum-refractory disease, the therapeutic options are reviewed. Much evidence supports the benefit of secondary cytoreductive surgery in platinum-sensitive patients, although this strategy has not yet been established by a prospective randomized clinical trial. Further, the standard chemotherapy regimens recommended in this setting are reviewed in the context of the clinical trials that established their efficacy. Finally, a description of emerging and investigational treatments, including both biologic agents and novel cytotoxic drugs, is included. Several recent and ongoing clinical trials involving these investigational agents are described. Throughout, the experts discuss the implication of these findings in the clinical setting.