[Drug therapy of ovarian carcinoma]

Patients with ovarian tumors of low malignant potential should be submitted exclusively to observation, but not to therapy. The same holds true for patients with epithelial ovarian cancer FIGO stages IA, IB with high and intermediate differentiation (G1/G2). All other patients with early stage ovarian cancer should be treated with adjuvant chemotherapy. There exists no standard therapy for these stages so far. The following options are actually under investigation: mono-chemotherapy with cisplatin or cyclophosphamide as well as combination therapy of cisplatin with cyclophosphamide or carboplatin with paclitaxel. The duration of adjuvant therapy is also subject of on-going trials. In patients with advanced ovarian cancer, platin-containing regimens yield longer survival rates than those without platin. Platin-containing combinations are more effective than equally dosed platin-monotherapy. With regard to the antitumoral effectiveness, no significant difference between cisplatin and its less toxic analogue carboplatin was found. Therefore, cisplatin may be substituted with carboplatin. Very recently, the combination of cisplatin with the taxane paclitaxel was shown significantly more efficacious than the old standard of platin plus cyclophosphamide with regard to response and survival rates representing actually the therapy of choice for the primary therapy of advanced ovarian cancer.