Current standards of care for chemotherapy of optimally cytoreduced advanced epithelial ovarian cancer

- Platinum-taxane chemotherapy remains the standard of care for the primary treatment of optimally cytoreduced advanced epithelial ovarian cancer
- Primary intraperitoneal cisplatin-based chemotherapy has been shown to improve survival in the setting of optimal residual advanced ovarian cancer
- The role of bevacizumab in the primary anti-neoplastic drug management of optimal residual advanced ovarian cancer remains to be defined

There has been limited change in evidence-based primary chemotherapeutic management of optimal residual advanced ovarian cancer for more than a decade. The backbone of therapy remains a platinum agent (generally carboplatin) and a taxane (generally paclitaxel). Phase 3 randomized trial data provide support for the use of weekly paclitaxel in this setting (compared to the traditional every 3-week schedule) and the addition of bevacizumab as a component of primary management. Recently available data provide increasingly solid support for a role of regional platinum administration in at least a subset of patients with optimal residual advanced ovarian cancer and an important retrospective analysis has suggested a novel biomarker that may predict for the utility (or lack thereof) of this method of drug delivery.