Management of partially platinum-sensitive relapsed ovarian cancer

A platinum-taxane doublet has been established as the standard of care in the initial chemotherapy for ovarian cancer. Treatment at relapse is based largely on the platinum-free interval (PFI). Women with a PFI of 6-12 months are said to be partially platinum-sensitive. Based on the evidence from randomised trials, many clinicians offer treatment to this group with a platinum-containing doublet (including paclitaxel or gemcitabine). A promising third option under investigation is the combination of liposomal doxorubicin (PLD) with carboplatin. However, monotherapy with drugs such as PLD or carboplatin is an accepted alternative, and treatment is often chosen on an individual basis or because of the availability of an appropriate clinical study. Extending the PFI by the use of non-platinum monotherapy such as PLD at first-relapse may theoretically be helpful, but would need confirmation in prospective randomised trials.