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Medical treatment for relapsed epithelial ovarian, fallopian tubal, or peritoneal cancer: Platinum-sensitive disease

Robert L Coleman, MD
Paul Sabbatini, MD
Section Editor
Don S Dizon, MD, FACP
Deputy Editor
Sadhna R Vora, MD


Epithelial cancers of ovarian, fallopian tubal, and peritoneal origin exhibit similar clinical characteristics, behavior, and in many cases, share basic biology. As such, these are often considered collectively and define epithelial ovarian cancer (EOC) in clinical trials and clinical practice. This topic will consider all three primary sites under the heading EOC.

Despite initial therapy (usually consisting of surgical cytoreduction and platinum-taxane combination therapy), the majority of women with advanced-stage ovarian cancer will relapse and require additional treatment. The likelihood for recurrence depends on many factors, including distribution of disease at initial presentation, success of initial surgical cytoreduction (ie, the presence of any residual disease), rapidity of cancer antigen 125 (CA-125) resolution, and treatment response after primary therapy. However, a predictive marker for recurrence has not been prospectively verified.

The management of patients with platinum-sensitive recurrent ovarian cancer (ie, those with a platinum-free interval of six months or longer) is discussed here. (See 'Relevance of the platinum-free interval' below.)

The management of patients with platinum-resistant disease (those with a platinum-free interval of less than six months), as well as the initial diagnosis and management of EOC, and the surgical treatment of recurrent EOC are covered separately. (See "Medical treatment for relapsed epithelial ovarian, fallopian tubal, or peritoneal cancer: Platinum-resistant disease" and "Overview of epithelial carcinoma of the ovary, fallopian tube, and peritoneum" and "Cancer of the ovary, fallopian tube, and peritoneum: Surgery for recurrent cancer" and "First-line chemotherapy for advanced (stage III or IV) epithelial ovarian, fallopian tubal, and peritoneal cancer" and "Epithelial carcinoma of the ovary, fallopian tube, and peritoneum: Clinical features and diagnosis".)


The management of relapsed disease is frequently stratified based upon the amount of time that has elapsed between the completion of platinum-based treatment and the detection of relapse, known as the platinum-free interval (PFI). This is because the PFI correlates with progression-free survival (PFS), overall survival (OS), and response to subsequent treatment (both with platinum and nonplatinum agents as well as cytoreduction):


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Literature review current through: Mar 2017. | This topic last updated: Apr 24, 2017.
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