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Ovarian

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Chemotherapy for Ovarian Cancer

Taxol+Carboplatin

Taxol 175 mg/m2 CIV over 3 h
Carboplatin AUC 6.0

Repeat every 3 weeks.

Ref. McGuire W.P.: Proc.: ASCO 1993; 12:255
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Taxo(3 hr)-Cisplatin

Taxol 175 mg/m2 CIV over 3h Day 1.
Cisplatin 75 mg/m2 IVPB day 2.

Repeat every 3 weeks.

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Cyclophosphamide-Cisplatin

Cyclophosphamide 1000 mg/m2 IVB day 1
Cisplatin 50 mg/m2 IV/2h day 1

Repeat cycle every 28 days.

Ref: Decker DG, et al: Obstet Gynecol 60:481 (1982).


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Taxol(24 hr)

Taxol 135 mg/m2 CIV over 24h


Repeat every 3 weeks.

Ref: Trimble EL, Adams D, Hawkins MJ, et al: J Clin Oncol 11:2405-2410, 1993.

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Ovarian Cancer Early Stage Risk Assignment:
LOW RISK:
Stage IA or IB with Grade 1 or 2
HIGH RISK:
Stage I with Grade 3
Stage IC with ruptured capsule, ascites, positive peritoneal cytology, or tumor on the surface of ovary
Stage II
Clear cell histology

AGENTS WITH DEMONSTRATED ACTIVITY IN >10% PTS WITH PLATINUM REFRACTORY DISEASE:
. ALTRETAMINE
260 mg/m2/day PO x 14 days
Toxicity: emesis , peripheral neuropathy
. DOCETAXEL
60 mg/m2 IV Q21 days
. EPIRUBICIN
. ETOPOSIDE(oral, 21 days)
50 mg/day or
50 mg/m2/day PO
X 21 days followed by 1 week rest
. GEMCITIBINE
1000 mg/m2/week IV X 3 weeks
followed by 1 week rest
. IFOSFAMIDE
. LIPOSOMAL DOXORUBICIN
50 mg/m2 IV Q 28 days
Toxicity: Hand-foot syndrome, stomatitis
. TAXOL (weekly)
60-80 mg/m2/week IV
. TAMOXIFEN-limited data
. TOPOTECAN
1.0-1.5 mg/m2/day IV X 5 days Q21
. VINORELBINE
25 mg/m2/week

Stage I: Growth limited to the ovaries.
->Stage IA: growth limited to one ovary; No tumor on the
external surface; capsule intact. No ascites.
->Stage IB: growth limited to both ovaries; No tumor on the
external surfaces; capsules intact. No ascites
->Stage IC: tumor either stage IA or IB, but with tumor on the surface of one or both ovaries; or with capsule ruptured; or with ascites present containing malignant cells or with positive peritoneal washings.


Stage II:Growth involving one or both ovaries with pelvic extension.
->Stage IIA: extension and/or metastases to the uterus and/or tubes.
->Stage IIB: extension to other pelvic tissues.
->Stage IIC: tumor either stage IIA or stage IIB, with tumor on the surface of one or both ovaries; or with capsule(s)ruptured; or with ascites present containing malignant cells or with positive peritoneal washings.

Stage III: tumor involving one or both ovaries with peritoneal implants outside the pelvis and/or positive retroperitoneal or inguinal nodes. Superficial liver metastasis equals stage III. Tumor is limited to the true pelvis but with histologically verified malignant extension to small bowel or omentum.

->Stage IIIA: tumor grossly limited to the true pelvis with negative nodes but with histologically confirmed microscopic seeding of abdominal peritoneal surfaces.
->Stage IIIB: tumor of one or both ovaries with histologically confirmed implants of abdominal peritoneal surfaces, none exceeding 2 centimeters in diameter. Nodes negative.
->Stage IIIC: abdominal implants greater than 2 centimeters in diameter and/or positive retroperitoneal or inguinal nodes.

Stage IV: Growth involving one or both ovaries with distant metastasis. If pleural effusion is present, there must be positive cytologic test results to allot a case to stage IV. Parenchymal liver metastasis equals stage IV