Ovarian Cancer Treatment After 6 Cycles of Chemotherapy

Assessment and Treatment Decision

For a patient with ovarian cancer who has completed 6 cycles of chemotherapy and shows clinical response but has residual disease, the European Society for Medical Oncology recommends considering an additional 3 cycles of the same chemotherapy regimen if CA125 continues to show evidence of ongoing response 1, 2, 3
The British Gynaecological Cancer Society suggests a clinical examination to assess response, CA125 measurement, CT scan of abdomen and pelvis, and abdominal ultrasound to identify any residual mass and monitor hepatic or splenic metastases 4, 5, 6

The National Comprehensive Cancer Network recommends considering 3 additional cycles of the same chemotherapy regimen (carboplatin + paclitaxel) if partial response with continuing evidence of response by CA125 is observed 1, 2, 3
The American Cancer Society states that current data do not support maintenance/consolidation treatment beyond 6 cycles as standard practice, but the option of 12 months of paclitaxel maintenance may be discussed with patients regarding potential progression-free survival improvement 1, 2, 3

The European Society for Medical Oncology recommends clinical examination including pelvic examination every 3 months for 2 years, every 4 months during year 3, and every 6 months during years 4-5, and CA125 measurement at each follow-up visit 1, 2, 3, 7, 8
The American College of Obstetricians and Gynecologists suggests CT scans only if there is clinical or CA125 evidence of progressive disease 1, 2, 3, 7, 8

The National Comprehensive Cancer Network recommends offering platinum-based combination chemotherapy (carboplatin + paclitaxel or carboplatin + gemcitabine) if disease recurs after a treatment-free interval of more than 6 months from initial chemotherapy 1, 2, 3, 7, 8
The Society of Gynecologic Oncology considers surgical resection of recurrent disease if the recurrence occurs more than 1 year from primary surgery 1, 2, 3, 7, 8