Chemotherapy may be given after surgery for some types of ovarian cancer.
Chemotherapy is the use of anti-cancer (cytotoxic) drugs to treat cancer. It is usually a systemic therapysystemic therapyTreatment that travels through the bloodstream to reach cells all over the body. that circulates throughout the body and destroys cancer cells, including those that may have broken away from the primary tumour.
Chemotherapy for ovarian cancer may be given intravenously (into a vein) or by intraperitoneal (IP) chemotherapy. During IP chemotherapy, drugs are injected directly into the space between the abdominal organs and the membrane lining the abdominal wall (peritoneal space or peritoneal cavity). This requires the surgical placement of a special intra-peritoneal port. The port allows the drugs to be safely delivered. The surgeon may place the port at the time of surgery for the ovarian cancer, or as a separate surgery.
When drugs are given during IP chemotherapy, they circulate and treat tumours throughout the abdomen. The drugs are also absorbed into the bloodstream, so IP chemotherapy is considered to be a type of systemic chemotherapy. IP chemotherapy is given in addition to intravenous chemotherapy.
Chemotherapy may be used:
Drugs, doses and schedules vary from woman to woman.
Chemotherapy is commonly used to treat epithelial ovarian cancer.
The most common chemotherapy drugs used to treat epithelial ovarian cancer are the platinum drugs:
The most common chemotherapy combinations used to treat epithelial ovarian cancer include a platinum drug and a taxane, such as:
Different drugs (secondary chemotherapy) may be given if epithelial ovarian cancer does not respond to carboplatin, cisplatin or a combination of these drugs with a taxane. Secondary chemotherapy is also given if epithelial ovarian cancer recurs.The type of drug used for secondary chemotherapy will depend on if the cancer is platinum-sensitive, platinum-refractory or platinum-resistant.
Recurrent epithelial ovarian cancer will be treated with a combination of drugs.
Targeted therapy uses drugs to target specific molecules (such as proteins) on or inside cancer cells. These molecules help send signals that tell cells to grow or divide. By targeting these molecules, the drugs stop the growth and spread of cancer cells while limiting harm to normal cells.
Olaparib (Lynparza) is a type of poly ADP ribose polymerase (PARP) inhibitor. PARP is a group of proteins that helps repair damage to DNA. PARP inhibitors block PARP in cancer cells, causing them to die. This treatment may be offered to women who have epithelial ovarian cancer with BRCA1 gene mutations that has responded to platinum-based chemotherapy. It is given by itself to stop or slow the cancer from recurring (called maintenance therapy).
IP chemotherapy may be offered to women with stage III epithelial ovarian cancer who still have tumours smaller than 1 cm in size after primary surgical debulking. For the chemotherapy to be effective, there can only be a small amount of cancer left in the abdomen.
Chemotherapy is used less often to treat ovarian stromal tumours. When it is given, the most common chemotherapy combinations used are:
Hormonal therapy is often used to treat ovarian stromal tumours. If an ovarian stromal tumour does not respond to chemotherapy or hormonal therapy drugs used in earlier treatments, or if it recurs, another combination of drugs may be used.
Chemotherapy is commonly used to treat ovarian germ cell tumours.
The most common chemotherapy combinations used to treat ovarian germ cell tumours are:
If the ovarian germ cell tumour does not respond to drugs used in earlier treatments or if it recurs, other drugs that may be used are:
Chemotherapy is commonly used to treat extra-ovarian primary peritoneal carcinoma. The same chemotherapy drugs and combinations of drugs used to treat epithelial ovarian cancer are used to treat extra-ovarian primary peritoneal carcinoma.
For more detailed information on specific drugs, go to sources of drug information.