Difference between revisions of "Ovarian cancer"
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=Primary chemotherapy for advanced/metastatic disease= | =Primary chemotherapy for advanced/metastatic disease= | ||
| − | ==Carboplatin | + | ==Carboplatin & Docetaxel== |
| − | ===Regimen=== | + | ===Regimen, Vasey, et al. 2004=== |
| − | *[[Carboplatin (Paraplatin)]] AUC 5 IV over 1 hour on day 1, given second | + | *[[Carboplatin (Paraplatin)]] AUC 5 IV over 1 hour once on day 1, given second |
| − | *[[Docetaxel (Taxotere)]] 75 mg/m2 IV over 1 hour on day 1, given first | + | *[[Docetaxel (Taxotere)]] 75 mg/m2 IV over 1 hour once on day 1, given first |
'''21-day cycles x 6 cycles''' | '''21-day cycles x 6 cycles''' | ||
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# Vasey PA, Jayson GC, Gordon A, Gabra H, Coleman R, Atkinson R, Parkin D, Paul J, Hay A, Kaye SB; Scottish Gynaecological Cancer Trials Group. Phase III randomized trial of docetaxel-carboplatin versus paclitaxel-carboplatin as first-line chemotherapy for ovarian carcinoma. J Natl Cancer Inst. 2004 Nov 17;96(22):1682-91. [http://jnci.oxfordjournals.org/content/96/22/1682.long link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/15547181 PubMed] | # Vasey PA, Jayson GC, Gordon A, Gabra H, Coleman R, Atkinson R, Parkin D, Paul J, Hay A, Kaye SB; Scottish Gynaecological Cancer Trials Group. Phase III randomized trial of docetaxel-carboplatin versus paclitaxel-carboplatin as first-line chemotherapy for ovarian carcinoma. J Natl Cancer Inst. 2004 Nov 17;96(22):1682-91. [http://jnci.oxfordjournals.org/content/96/22/1682.long link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/15547181 PubMed] | ||
| − | ==Carboplatin | + | ==Carboplatin & Gemcitabine== |
| − | ===Regimen=== | + | ===Regimen, Gordon, et al. 2011=== |
| − | *[[Carboplatin (Paraplatin)]] AUC 5 IV over 30 minutes on day 1, given second | + | *[[Carboplatin (Paraplatin)]] AUC 5 IV over 30 minutes once on day 1, given second |
| − | *[[Gemcitabine (Gemzar)]] 1000 mg/m2 IV 30 minutes on days 1 & 8, given first | + | *[[Gemcitabine (Gemzar)]] 1000 mg/m2 IV 30 minutes once per day on days 1 & 8, given first |
'''21-day cycles x up to 6 cycles; patients with complete response could optionally proceed to receive consolidation''' | '''21-day cycles x up to 6 cycles; patients with complete response could optionally proceed to receive consolidation''' | ||
| − | Consolidation | + | ====Consolidation==== |
| − | *[[Paclitaxel (Taxol)]] 135 mg/m2 IV on day 1 | + | *[[Paclitaxel (Taxol)]] 135 mg/m2 IV once on day 1 |
'''28-day cycles x up to 12 cycles''' | '''28-day cycles x up to 12 cycles''' | ||
| Line 35: | Line 35: | ||
# Gordon AN, Teneriello M, Janicek MF, Hines J, Lim PC, Chen MD, Vaccarello L, Homesley HD, McMeekin S, Burkholder TL, Wang Y, Zhao L, Orlando M, Obasaju CK, Gill JF, Tai DF. Phase III trial of induction gemcitabine or paclitaxel plus carboplatin followed by paclitaxel consolidation in ovarian cancer. Gynecol Oncol. 2011 Dec;123(3):479-85. Epub 2011 Oct 5. [http://www.sciencedirect.com/science/article/pii/S0090825811007037 link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/21978765 PubMed] | # Gordon AN, Teneriello M, Janicek MF, Hines J, Lim PC, Chen MD, Vaccarello L, Homesley HD, McMeekin S, Burkholder TL, Wang Y, Zhao L, Orlando M, Obasaju CK, Gill JF, Tai DF. Phase III trial of induction gemcitabine or paclitaxel plus carboplatin followed by paclitaxel consolidation in ovarian cancer. Gynecol Oncol. 2011 Dec;123(3):479-85. Epub 2011 Oct 5. [http://www.sciencedirect.com/science/article/pii/S0090825811007037 link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/21978765 PubMed] | ||
| − | ==Carboplatin | + | ==Carboplatin & Paclitaxel== |
===Regimen #1, Ozols, et al. 2003=== | ===Regimen #1, Ozols, et al. 2003=== | ||
| − | *[[Carboplatin (Paraplatin)]] AUC 7.5 IV on day 1 | + | *[[Carboplatin (Paraplatin)]] AUC 7.5 IV once on day 1 |
| − | *[[Paclitaxel (Taxol)]] 175 mg/m2 IV over 3 hours on day 1 | + | *[[Paclitaxel (Taxol)]] 175 mg/m2 IV over 3 hours once on day 1 |
'''21-day cycles x 6 cycles''' | '''21-day cycles x 6 cycles''' | ||
Supportive medications: | Supportive medications: | ||
| − | *[[Dexamethasone (Decadron)]] 20 mg PO 12 and 6 hours prior to chemotherapy OR 20 mg IV 30 minutes prior to paclitaxel | + | *[[Dexamethasone (Decadron)]] 20 mg PO given twice, at 12 and 6 hours prior to chemotherapy OR 20 mg IV once 30 minutes prior to paclitaxel |
| − | *Diphenhydramine (Benadryl) 50 mg IV 30 minutes prior to paclitaxel | + | *Diphenhydramine (Benadryl) 50 mg IV once 30 minutes prior to paclitaxel |
| − | *Cimetidine (Tagamet) 300 mg IV 30 minutes prior to paclitaxel | + | *Cimetidine (Tagamet) 300 mg IV once 30 minutes prior to paclitaxel |
===Regimen #2, Vasey, et al. 2004=== | ===Regimen #2, Vasey, et al. 2004=== | ||
| − | *[[Carboplatin (Paraplatin)]] AUC 5 IV over 1 hour on day 1, given second | + | *[[Carboplatin (Paraplatin)]] AUC 5 IV over 1 hour once on day 1, given second |
| − | *[[Paclitaxel (Taxol)]] 175 mg/m2 IV over 3 hours on day 1, given first | + | *[[Paclitaxel (Taxol)]] 175 mg/m2 IV over 3 hours once on day 1, given first |
'''21-day cycles x 6 cycles''' | '''21-day cycles x 6 cycles''' | ||
Supportive medications: | Supportive medications: | ||
| − | *[[Dexamethasone (Decadron)]] 20 mg PO 12 and 6 hours prior to paclitaxel | + | *[[Dexamethasone (Decadron)]] 20 mg PO given twice, at 12 and 6 hours prior to paclitaxel |
| − | *Diphenhydramine (Benadryl) 50 mg IV or chlorpheniramine 10 mg IV 30 minutes prior to paclitaxel | + | *Diphenhydramine (Benadryl) 50 mg IV or chlorpheniramine 10 mg IV once 30 minutes prior to paclitaxel |
| − | *Ranitidine (Zantac) 50 mg IV or Cimetidine (Tagamet) 300 mg IV 30 minutes prior to paclitaxel | + | *Ranitidine (Zantac) 50 mg IV or Cimetidine (Tagamet) 300 mg IV once 30 minutes prior to paclitaxel |
*Ondansetron (Zofran) 8 mg or Granisetron (Kytril) 3 mg for [[antiemesis]] | *Ondansetron (Zofran) 8 mg or Granisetron (Kytril) 3 mg for [[antiemesis]] | ||
===Regimen #3, Katsumata, et al. 2009=== | ===Regimen #3, Katsumata, et al. 2009=== | ||
| − | *[[Carboplatin (Paraplatin)]] AUC 6 IV over 1 hour on day 1 | + | *[[Carboplatin (Paraplatin)]] AUC 6 IV over 1 hour once on day 1 |
| − | *[[Paclitaxel (Taxol)]] 180 mg/m2 IV over 3 hours on day 1 | + | *[[Paclitaxel (Taxol)]] 180 mg/m2 IV over 3 hours once on day 1 |
| − | '''21-day cycles x 6 | + | '''21-day cycles x 6 to 9 cycles, depending on response''' |
Supportive medications: | Supportive medications: | ||
*"Standard premedication" | *"Standard premedication" | ||
| − | ===Regimen #4 | + | ===Regimen #4, Katsumata, et al. 2009 (weekly paclitaxel)=== |
| − | *[[Carboplatin (Paraplatin)]] AUC 6 IV over 1 hour on day 1 | + | *[[Carboplatin (Paraplatin)]] AUC 6 IV over 1 hour once on day 1 |
| − | *[[Paclitaxel (Taxol)]] 80 mg/m2 IV over 1 hour on days 1, 8, 15 | + | *[[Paclitaxel (Taxol)]] 80 mg/m2 IV over 1 hour once per day on days 1, 8, 15 |
| − | '''21-day cycles x 6 | + | '''21-day cycles x 6 to 9 cycles, depending on response''' |
Supportive medications: | Supportive medications: | ||
| Line 78: | Line 78: | ||
===Regimen #5, Gordon, et al. 2011=== | ===Regimen #5, Gordon, et al. 2011=== | ||
| − | *[[Carboplatin (Paraplatin)]] AUC 6 IV over 30 minutes on day 1 | + | *[[Carboplatin (Paraplatin)]] AUC 6 IV over 30 minutes once on day 1 |
| − | *[[Paclitaxel (Taxol)]] 175 mg/m2 IV over 3 hours on day 1 | + | *[[Paclitaxel (Taxol)]] 175 mg/m2 IV over 3 hours once on day 1 |
'''21-day cycles x up to 6 cycles; patients with complete response could optionally proceed to receive consolidation''' | '''21-day cycles x up to 6 cycles; patients with complete response could optionally proceed to receive consolidation''' | ||
| − | Consolidation | + | ====Consolidation==== |
| − | *[[Paclitaxel (Taxol)]] 135 mg/m2 IV on day 1 | + | *[[Paclitaxel (Taxol)]] 135 mg/m2 IV once on day 1 |
'''28-day cycles x up to 12 cycles''' | '''28-day cycles x up to 12 cycles''' | ||
===Regimen #6, Burger, et al. 2011 & Perren, et al. 2011=== | ===Regimen #6, Burger, et al. 2011 & Perren, et al. 2011=== | ||
| − | *[[Carboplatin (Paraplatin)]] AUC 6 IV over 30 minutes on day 1 | + | *[[Carboplatin (Paraplatin)]] AUC 6 IV over 30 minutes once on day 1 |
| − | *[[Paclitaxel (Taxol)]] 175 mg/m2 IV over 3 hours on day 1 | + | *[[Paclitaxel (Taxol)]] 175 mg/m2 IV over 3 hours once on day 1 |
'''21-day cycles x 6 cycles''' | '''21-day cycles x 6 cycles''' | ||
| Line 102: | Line 102: | ||
# Perren TJ, Swart AM, Pfisterer J, Ledermann JA, Pujade-Lauraine E, Kristensen G, Carey MS, Beale P, Cervantes A, Kurzeder C, du Bois A, Sehouli J, Kimmig R, Stähle A, Collinson F, Essapen S, Gourley C, Lortholary A, Selle F, Mirza MR, Leminen A, Plante M, Stark D, Qian W, Parmar MK, Oza AM; ICON7 Investigators. A phase 3 trial of bevacizumab in ovarian cancer. N Engl J Med. 2011 Dec 29;365(26):2484-96. [http://www.nejm.org/doi/full/10.1056/NEJMoa1103799 link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/22204725 PubMed] | # Perren TJ, Swart AM, Pfisterer J, Ledermann JA, Pujade-Lauraine E, Kristensen G, Carey MS, Beale P, Cervantes A, Kurzeder C, du Bois A, Sehouli J, Kimmig R, Stähle A, Collinson F, Essapen S, Gourley C, Lortholary A, Selle F, Mirza MR, Leminen A, Plante M, Stark D, Qian W, Parmar MK, Oza AM; ICON7 Investigators. A phase 3 trial of bevacizumab in ovarian cancer. N Engl J Med. 2011 Dec 29;365(26):2484-96. [http://www.nejm.org/doi/full/10.1056/NEJMoa1103799 link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/22204725 PubMed] | ||
| − | ==Carboplatin | + | ==Carboplatin, Paclitaxel, Bevacizumab== |
| − | ===Regimen #1, Burger, et al. 2011 | + | ===Regimen #1, Burger, et al. 2011 (GOG-0218)=== |
| − | *[[Carboplatin (Paraplatin)]] AUC 6 IV over 30 minutes on day 1 | + | *[[Carboplatin (Paraplatin)]] AUC 6 IV over 30 minutes once on day 1 |
| − | *[[Paclitaxel (Taxol)]] 175 mg/m2 IV over 3 hours on day 1 | + | *[[Paclitaxel (Taxol)]] 175 mg/m2 IV over 3 hours once on day 1 |
'''21-day cycle x 1 cycle, then''' | '''21-day cycle x 1 cycle, then''' | ||
| − | *[[Carboplatin (Paraplatin)]] AUC 6 IV over 30 minutes on day 1 | + | *[[Carboplatin (Paraplatin)]] AUC 6 IV over 30 minutes once on day 1 |
| − | *[[Paclitaxel (Taxol)]] 175 mg/m2 IV over 3 hours on day 1 | + | *[[Paclitaxel (Taxol)]] 175 mg/m2 IV over 3 hours once on day 1 |
| − | *[[Bevacizumab (Avastin)]] 15 mg/kg IV on day 1 | + | *[[Bevacizumab (Avastin)]] 15 mg/kg IV once on day 1 |
'''21-day cycles x 5 cycles, then''' | '''21-day cycles x 5 cycles, then''' | ||
| − | *[[Bevacizumab (Avastin)]] 15 mg/kg IV on day 1 | + | *[[Bevacizumab (Avastin)]] 15 mg/kg IV once on day 1 |
'''21-day cycles x up to 16 cycles''' | '''21-day cycles x up to 16 cycles''' | ||
| − | ===Regimen #2, Perren, et al. 2011 | + | ===Regimen #2, Perren, et al. 2011 (ICON7)=== |
| − | *[[Carboplatin (Paraplatin)]] AUC 5 | + | *[[Carboplatin (Paraplatin)]] AUC 5 to 6 IV over 30 to 60 minutes once on day 1; the protocol linked from Perren, et al. 2011 clarifies that the recommended dose was AUC 6, but that it could be adjusted "according to standard practice" |
| − | *[[Paclitaxel (Taxol)]] 175 mg/m2 IV over 3 hours on day 1 | + | *[[Paclitaxel (Taxol)]] 175 mg/m2 IV over 3 hours once on day 1 |
| − | *Bevacizumab is not given in cycle 1 if chemotherapy starts within 4 weeks of surgery. If >4 weeks after surgery: [[Bevacizumab (Avastin)]] 7.5 mg/kg IV on day 1 | + | *Bevacizumab is not given in cycle 1 if chemotherapy starts within 4 weeks of surgery. If >4 weeks after surgery: [[Bevacizumab (Avastin)]] 7.5 mg/kg IV once on day 1 |
'''21-day cycle x 1 cycle, then''' | '''21-day cycle x 1 cycle, then''' | ||
| − | *[[Carboplatin (Paraplatin)]] AUC 5 | + | *[[Carboplatin (Paraplatin)]] AUC 5 to 6 IV over 30 to 60 minutes once on day 1 |
| − | *[[Paclitaxel (Taxol)]] 175 mg/m2 IV over 3 hours on day 1 | + | *[[Paclitaxel (Taxol)]] 175 mg/m2 IV over 3 hours once on day 1 |
| − | *[[Bevacizumab (Avastin)]] 7.5 mg/kg IV on day 1 | + | *[[Bevacizumab (Avastin)]] 7.5 mg/kg IV once on day 1 |
'''21-day cycles x 5 cycles, then''' | '''21-day cycles x 5 cycles, then''' | ||
| − | *[[Bevacizumab (Avastin)]] 15 mg/kg IV on day 1 | + | *[[Bevacizumab (Avastin)]] 15 mg/kg IV once on day 1 |
'''21-day cycles x 12 cycles''' | '''21-day cycles x 12 cycles''' | ||
| Line 140: | Line 140: | ||
# Perren TJ, Swart AM, Pfisterer J, Ledermann JA, Pujade-Lauraine E, Kristensen G, Carey MS, Beale P, Cervantes A, Kurzeder C, du Bois A, Sehouli J, Kimmig R, Stähle A, Collinson F, Essapen S, Gourley C, Lortholary A, Selle F, Mirza MR, Leminen A, Plante M, Stark D, Qian W, Parmar MK, Oza AM; ICON7 Investigators. A phase 3 trial of bevacizumab in ovarian cancer. N Engl J Med. 2011 Dec 29;365(26):2484-96. [http://www.nejm.org/doi/full/10.1056/NEJMoa1103799 link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/22204725 PubMed] | # Perren TJ, Swart AM, Pfisterer J, Ledermann JA, Pujade-Lauraine E, Kristensen G, Carey MS, Beale P, Cervantes A, Kurzeder C, du Bois A, Sehouli J, Kimmig R, Stähle A, Collinson F, Essapen S, Gourley C, Lortholary A, Selle F, Mirza MR, Leminen A, Plante M, Stark D, Qian W, Parmar MK, Oza AM; ICON7 Investigators. A phase 3 trial of bevacizumab in ovarian cancer. N Engl J Med. 2011 Dec 29;365(26):2484-96. [http://www.nejm.org/doi/full/10.1056/NEJMoa1103799 link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/22204725 PubMed] | ||
| − | ==Cisplatin | + | ==Cisplatin & Paclitaxel== |
| − | ===Regimen=== | + | ===Regimen, Ozols, et al. 2003; Armstrong, et al. 2006; Walker, et al. 2006=== |
| − | *[[Cisplatin (Platinol)]] 75 mg/m2 IV at an infusion rate of 1 mg/min on day 1 | + | *[[Cisplatin (Platinol)]] 75 mg/m2 IV at an infusion rate of 1 mg/min once on day 1 |
| − | *[[Paclitaxel (Taxol)]] 135 mg/m2 IV continuous infusion over 24 hours on day 1 | + | *[[Paclitaxel (Taxol)]] 135 mg/m2 IV continuous infusion over 24 hours once on day 1 |
'''21-day cycles x 6 cycles''' | '''21-day cycles x 6 cycles''' | ||
Supportive medications (details vary depending on reference): | Supportive medications (details vary depending on reference): | ||
| − | *[[Dexamethasone (Decadron)]] 20 mg PO 12 and 6 hours prior to chemotherapy OR 20 mg IV 30 minutes prior to paclitaxel | + | *[[Dexamethasone (Decadron)]] 20 mg PO given twice, at 12 and 6 hours prior to chemotherapy OR 20 mg IV once 30 minutes prior to paclitaxel |
| − | *Diphenhydramine (Benadryl) 50 mg IV 30 minutes prior to paclitaxel | + | *Diphenhydramine (Benadryl) 50 mg IV once 30 minutes prior to paclitaxel |
| − | *Cimetidine (Tagamet) 300 mg IV 30 minutes prior to paclitaxel | + | *Cimetidine (Tagamet) 300 mg IV once 30 minutes prior to paclitaxel |
*"Hydration and [[antiemesis|antiemetic agents]]" before cisplatin | *"Hydration and [[antiemesis|antiemetic agents]]" before cisplatin | ||
| Line 160: | Line 160: | ||
=Maintenance/consolidation therapy= | =Maintenance/consolidation therapy= | ||
==Altretamine (Hexalen)== | ==Altretamine (Hexalen)== | ||
| − | ===Regimen=== | + | ===Regimen, Alberts, et al. 2004=== |
| − | *[[Altretamine (Hexalen)]] 260 mg/m2 PO on days 1 | + | *[[Altretamine (Hexalen)]] 260 mg/m2 PO once per day on days 1 to 14 |
'''28-day cycles''' | '''28-day cycles''' | ||
| Line 170: | Line 170: | ||
==Paclitaxel (Taxol)== | ==Paclitaxel (Taxol)== | ||
===Regimen #1, Markman, et al. 2003 & Markman, et al. 2009=== | ===Regimen #1, Markman, et al. 2003 & Markman, et al. 2009=== | ||
| − | *[[Paclitaxel (Taxol)]] 135 or 175 mg/m2 IV over 3 hours on day 1 | + | *[[Paclitaxel (Taxol)]] 135 or 175 mg/m2 IV over 3 hours once on day 1 |
'''28-day cycles x 12 cycles''' | '''28-day cycles x 12 cycles''' | ||
===Regimen #2, Micha, et al. 2005 & Abaid, et al. 2010=== | ===Regimen #2, Micha, et al. 2005 & Abaid, et al. 2010=== | ||
| − | *[[Paclitaxel (Taxol)]] 135 mg/m2 IV over 1 hour on day 1 | + | *[[Paclitaxel (Taxol)]] 135 mg/m2 IV over 1 hour once on day 1 |
'''21-day cycles x 12 cycles''' | '''21-day cycles x 12 cycles''' | ||
| Line 187: | Line 187: | ||
# Markman M, Liu PY, Moon J, Monk BJ, Copeland L, Wilczynski S, Alberts D. Impact on survival of 12 versus 3 monthly cycles of paclitaxel (175 mg/m2) administered to patients with advanced ovarian cancer who attained a complete response to primary platinum-paclitaxel: follow-up of a Southwest Oncology Group and Gynecologic Oncology Group phase 3 trial. Gynecol Oncol. 2009 Aug;114(2):195-8. Epub 2009 May 17. [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2744303 link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/19447479 PubMed] | # Markman M, Liu PY, Moon J, Monk BJ, Copeland L, Wilczynski S, Alberts D. Impact on survival of 12 versus 3 monthly cycles of paclitaxel (175 mg/m2) administered to patients with advanced ovarian cancer who attained a complete response to primary platinum-paclitaxel: follow-up of a Southwest Oncology Group and Gynecologic Oncology Group phase 3 trial. Gynecol Oncol. 2009 Aug;114(2):195-8. Epub 2009 May 17. [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2744303 link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/19447479 PubMed] | ||
# Abaid LN, Goldstein BH, Micha JP, Rettenmaier MA, Brown JV 3rd, Markman M. Improved overall survival with 12 cycles of single-agent paclitaxel maintenance therapy following a complete response to induction chemotherapy in advanced ovarian carcinoma. Oncology. 2010;78(5-6):389-93. Epub 2010 Aug 27. [http://content.karger.com/ProdukteDB/produkte.asp?Aktion=ShowAbstract&ArtikelNr=000320579&Ausgabe=254415&ProduktNr=223857 link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/20798562 PubMed] | # Abaid LN, Goldstein BH, Micha JP, Rettenmaier MA, Brown JV 3rd, Markman M. Improved overall survival with 12 cycles of single-agent paclitaxel maintenance therapy following a complete response to induction chemotherapy in advanced ovarian carcinoma. Oncology. 2010;78(5-6):389-93. Epub 2010 Aug 27. [http://content.karger.com/ProdukteDB/produkte.asp?Aktion=ShowAbstract&ArtikelNr=000320579&Ausgabe=254415&ProduktNr=223857 link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/20798562 PubMed] | ||
| + | |||
| + | ==Pazopanib (Votrient)== | ||
| + | ===Regimen, Du Bois, et al. 2013 (AGO-OVAR16)=== | ||
| + | ''Patients enrolled in Du Bois, et al. 2013 (AGO-OVAR16) had histologically confirmed advanced epithelial ovarian, fallopian tube, or primary peritoneal cancer, were FIGO II to IV, and no evidence of progression after surgery and at least 5 cycles of platinum-taxane chemotherapy.'' | ||
| + | *[[Pazopanib (Votrient)]] 800 mg PO once per day | ||
| + | |||
| + | '''24-month course''' | ||
| + | |||
| + | ===References=== | ||
| + | # Andreas Du Bois, Anne Floquet, Jae Weon Kim, Jörn Rau, Jose Maria Del Campo, Michael Friedlander, Sandro Pignata, Keiichi Fujiwara, Ignace Vergote, Nicoletta Colombo, Mansoor Raza Mirza, Bradley J. Monk, Pauline Wimberger, Isabelle Ray-Coquard, Rongyu Zang, Ivan Diaz-Padilla, Klaus H. Baumann, Jae Hoon Kim, Philipp Harter. Randomized, double-blind, phase III trial of pazopanib versus placebo in women who have not progressed after first-line chemotherapy for advanced epithelial ovarian, fallopian tube, or primary peritoneal cancer (AEOC): Results of an international Intergroup trial (AGO-OVAR16). 2013 ASCO Annual Meeting abstract LBA5503. [http://meetinglibrary.asco.org/content/115898-132 link to abstract] | ||
=Intraperitoneal therapy= | =Intraperitoneal therapy= | ||
| − | ==Cisplatin | + | ==Cisplatin & Paclitaxel== |
===Regimen #1, Armstrong, et al. 2006=== | ===Regimen #1, Armstrong, et al. 2006=== | ||
| − | *[[Cisplatin (Platinol)]] 100 mg/m2 intraperitoneal rapid infusion on day 2 | + | *[[Cisplatin (Platinol)]] 100 mg/m2 intraperitoneal rapid infusion once on day 2 |
| − | *[[Paclitaxel (Taxol)]] 135 mg/m2 IV continuous infusion over 24 hours on day 1, then 60 mg/m2 intraperitoneal rapid infusion on day 8 | + | *[[Paclitaxel (Taxol)]] 135 mg/m2 IV continuous infusion over 24 hours once on day 1, then 60 mg/m2 intraperitoneal rapid infusion once on day 8 |
'''21-day cycles x 6 cycles''' | '''21-day cycles x 6 cycles''' | ||
| Line 199: | Line 209: | ||
*"Standard premedication" for paclitaxel | *"Standard premedication" for paclitaxel | ||
*"Hydration and [[antiemesis|antiemetic agents]]" before cisplatin | *"Hydration and [[antiemesis|antiemetic agents]]" before cisplatin | ||
| − | *Intraperitoneal doses of cisplatin and paclitaxel are reconstituted in 2 liters of warm normal saline before | + | *Intraperitoneal doses of cisplatin and paclitaxel are reconstituted in 2 liters of warm normal saline before infusion |
===Regimen #2, Walker, et al. 2006=== | ===Regimen #2, Walker, et al. 2006=== | ||
| − | *[[Cisplatin (Platinol)]] 100 mg/m2 in 2 liters of normal saline, intraperitoneal rapid infusion on day 2, with patient rolled onto 4 different positions every 15 minutes to evenly distribute cisplatin | + | *[[Cisplatin (Platinol)]] 100 mg/m2 in 2 liters of normal saline, intraperitoneal rapid infusion once on day 2, with patient rolled onto 4 different positions every 15 minutes to evenly distribute cisplatin |
| − | *[[Paclitaxel (Taxol)]] 135 mg/m2 IV continuous infusion over 24 hours on day 1, then 60 mg/m2 in 1 liter saline, intraperitoneal rapid infusion on day 8 | + | *[[Paclitaxel (Taxol)]] 135 mg/m2 IV continuous infusion over 24 hours once on day 1, then 60 mg/m2 in 1 liter saline, intraperitoneal rapid infusion once on day 8 |
'''21-day cycles x 6 cycles''' | '''21-day cycles x 6 cycles''' | ||
| Line 218: | Line 228: | ||
==Carboplatin (Paraplatin)== | ==Carboplatin (Paraplatin)== | ||
===Regimen=== | ===Regimen=== | ||
| − | *[[Carboplatin (Paraplatin)]] AUC 5 IV on day 1 | + | *[[Carboplatin (Paraplatin)]] AUC 5 IV once on day 1 |
| − | '''21-day cycles x 6 | + | '''21-day cycles x 6 to 10 cycles''' |
===References=== | ===References=== | ||
# Pfisterer J, Plante M, Vergote I, du Bois A, Hirte H, Lacave AJ, Wagner U, Stähle A, Stuart G, Kimmig R, Olbricht S, Le T, Emerich J, Kuhn W, Bentley J, Jackisch C, Lück HJ, Rochon J, Zimmermann AH, Eisenhauer E; AGO-OVAR; NCIC CTG; EORTC GCG. Gemcitabine plus carboplatin compared with carboplatin in patients with platinum-sensitive recurrent ovarian cancer: an intergroup trial of the AGO-OVAR, the NCIC CTG, and the EORTC GCG. J Clin Oncol. 2006 Oct 10;24(29):4699-707. Epub 2006 Sep 11. [http://jco.ascopubs.org/content/24/29/4699.long link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/16966687 PubMed] | # Pfisterer J, Plante M, Vergote I, du Bois A, Hirte H, Lacave AJ, Wagner U, Stähle A, Stuart G, Kimmig R, Olbricht S, Le T, Emerich J, Kuhn W, Bentley J, Jackisch C, Lück HJ, Rochon J, Zimmermann AH, Eisenhauer E; AGO-OVAR; NCIC CTG; EORTC GCG. Gemcitabine plus carboplatin compared with carboplatin in patients with platinum-sensitive recurrent ovarian cancer: an intergroup trial of the AGO-OVAR, the NCIC CTG, and the EORTC GCG. J Clin Oncol. 2006 Oct 10;24(29):4699-707. Epub 2006 Sep 11. [http://jco.ascopubs.org/content/24/29/4699.long link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/16966687 PubMed] | ||
| − | ==Carboplatin | + | ==Carboplatin & Docetaxel== |
===Regimen #1, Strauss, et al. 2007=== | ===Regimen #1, Strauss, et al. 2007=== | ||
| − | *[[Carboplatin (Paraplatin)]] AUC 5 IV over 30 | + | *[[Carboplatin (Paraplatin)]] AUC 5 IV over 30 to 60 minutes once on day 1, given second |
| − | *[[Docetaxel (Taxotere)]] 75 mg/m2 IV over 60 minutes on day 1, given first | + | *[[Docetaxel (Taxotere)]] 75 mg/m2 IV over 60 minutes once on day 1, given first |
'''21-day cycles x 6 cycles''' | '''21-day cycles x 6 cycles''' | ||
Supportive medications: | Supportive medications: | ||
| − | *Corticosteroids 12 hours and 30 minutes before docetaxel | + | *[[Steroid conversions|Corticosteroids]] given twice, 12 hours and 30 minutes before docetaxel |
*Prophylactic [[antiemesis|antiemetics]] with 5-HT3 antagonist | *Prophylactic [[antiemesis|antiemetics]] with 5-HT3 antagonist | ||
===Regimen #2, Kushner, et al. 2007=== | ===Regimen #2, Kushner, et al. 2007=== | ||
| − | *[[Carboplatin (Paraplatin)]] AUC 2 IV over 30 minutes on days 1, 8, 15, given second | + | *[[Carboplatin (Paraplatin)]] AUC 2 IV over 30 minutes once per day on days 1, 8, 15, given second |
| − | *[[Docetaxel (Taxotere)]] 35 mg/m2 IV over 60 minutes on days 1, 8, 15, given first | + | *[[Docetaxel (Taxotere)]] 35 mg/m2 IV over 60 minutes once per day on days 1, 8, 15, given first |
*Body surface area capped at 2 m2 | *Body surface area capped at 2 m2 | ||
| Line 245: | Line 255: | ||
Supportive medications: | Supportive medications: | ||
*[[Dexamethasone (Decadron)]] 4 mg PO the evening before, the morning of, and evening after docetaxel | *[[Dexamethasone (Decadron)]] 4 mg PO the evening before, the morning of, and evening after docetaxel | ||
| − | *5-HT3 antagonist before chemotherapy | + | *[[Antiemesis|5-HT3 antagonist]] before chemotherapy |
*Phenothiazine or 5-HT3 antagonist as needed as an outpatient | *Phenothiazine or 5-HT3 antagonist as needed as an outpatient | ||
| − | *Diphenhydramine (Benadryl) 50 mg IV immediately prior to docetaxel | + | *Diphenhydramine (Benadryl) 50 mg IV once immediately prior to docetaxel |
===References=== | ===References=== | ||
| Line 253: | Line 263: | ||
# Kushner DM, Connor JP, Sanchez F, Volk M, Schink JC, Bailey HH, Harris LS, Stewart SL, Fine J, Hartenbach EM; Wisconsin Oncology Network. Weekly docetaxel and carboplatin for recurrent ovarian and peritoneal cancer: a phase II trial. Gynecol Oncol. 2007 May;105(2):358-64. Epub 2007 Jan 29. [http://www.sciencedirect.com/science/article/pii/S0090825806010171 link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/17258800 PubMed] | # Kushner DM, Connor JP, Sanchez F, Volk M, Schink JC, Bailey HH, Harris LS, Stewart SL, Fine J, Hartenbach EM; Wisconsin Oncology Network. Weekly docetaxel and carboplatin for recurrent ovarian and peritoneal cancer: a phase II trial. Gynecol Oncol. 2007 May;105(2):358-64. Epub 2007 Jan 29. [http://www.sciencedirect.com/science/article/pii/S0090825806010171 link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/17258800 PubMed] | ||
| − | ==Carboplatin | + | ==Carboplatin & Doxorubicin liposomal== |
| − | ===Regimen=== | + | ===Regimen, Pujade-Lauraine, et al. 2010=== |
| − | *[[Carboplatin (Paraplatin)]] AUC 5 IV on day 1 | + | *[[Carboplatin (Paraplatin)]] AUC 5 IV once on day 1 |
| − | *[[Doxorubicin liposomal (Doxil)]] 30 mg/m2 IV on day 1 | + | *[[Doxorubicin liposomal (Doxil)]] 30 mg/m2 IV once on day 1 |
'''28-day cycles x 6 or more cycles, depending on response and toxicity''' | '''28-day cycles x 6 or more cycles, depending on response and toxicity''' | ||
Supportive medications (varies depending on reference): | Supportive medications (varies depending on reference): | ||
| − | *Corticosteroids and prophylactic [[antiemesis|antiemetics]] with 5-HT3 antagonist | + | *[[Steroid conversions|Corticosteroids]] and prophylactic [[antiemesis|antiemetics]] with 5-HT3 antagonist |
===References=== | ===References=== | ||
# Pujade-Lauraine E, Wagner U, Aavall-Lundqvist E, Gebski V, Heywood M, Vasey PA, Volgger B, Vergote I, Pignata S, Ferrero A, Sehouli J, Lortholary A, Kristensen G, Jackisch C, Joly F, Brown C, Le Fur N, du Bois A. Pegylated liposomal Doxorubicin and Carboplatin compared with Paclitaxel and Carboplatin for patients with platinum-sensitive ovarian cancer in late relapse. J Clin Oncol. 2010 Jul 10;28(20):3323-9. Epub 2010 May 24. [http://jco.ascopubs.org/content/28/20/3323.long link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/20498395 PubMed] | # Pujade-Lauraine E, Wagner U, Aavall-Lundqvist E, Gebski V, Heywood M, Vasey PA, Volgger B, Vergote I, Pignata S, Ferrero A, Sehouli J, Lortholary A, Kristensen G, Jackisch C, Joly F, Brown C, Le Fur N, du Bois A. Pegylated liposomal Doxorubicin and Carboplatin compared with Paclitaxel and Carboplatin for patients with platinum-sensitive ovarian cancer in late relapse. J Clin Oncol. 2010 Jul 10;28(20):3323-9. Epub 2010 May 24. [http://jco.ascopubs.org/content/28/20/3323.long link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/20498395 PubMed] | ||
| − | ==Carboplatin | + | ==Carboplatin & Gemcitabine== |
| − | ===Regimen=== | + | ===Regimen, Pfisterer, et al. 2006=== |
| − | *[[Carboplatin (Paraplatin)]] AUC 4 IV on day 1 | + | *[[Carboplatin (Paraplatin)]] AUC 4 IV once on day 1 |
| − | *[[Gemcitabine (Gemzar)]] 1000 mg/m2 IV on days 1 & 8 | + | *[[Gemcitabine (Gemzar)]] 1000 mg/m2 IV once per day on days 1 & 8 |
| − | '''21-day cycles x 6 | + | '''21-day cycles x 6 to 10 cycles''' |
===References=== | ===References=== | ||
# Pfisterer J, Plante M, Vergote I, du Bois A, Hirte H, Lacave AJ, Wagner U, Stähle A, Stuart G, Kimmig R, Olbricht S, Le T, Emerich J, Kuhn W, Bentley J, Jackisch C, Lück HJ, Rochon J, Zimmermann AH, Eisenhauer E; AGO-OVAR; NCIC CTG; EORTC GCG. Gemcitabine plus carboplatin compared with carboplatin in patients with platinum-sensitive recurrent ovarian cancer: an intergroup trial of the AGO-OVAR, the NCIC CTG, and the EORTC GCG. J Clin Oncol. 2006 Oct 10;24(29):4699-707. Epub 2006 Sep 11. [http://jco.ascopubs.org/content/24/29/4699.long link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/16966687 PubMed] | # Pfisterer J, Plante M, Vergote I, du Bois A, Hirte H, Lacave AJ, Wagner U, Stähle A, Stuart G, Kimmig R, Olbricht S, Le T, Emerich J, Kuhn W, Bentley J, Jackisch C, Lück HJ, Rochon J, Zimmermann AH, Eisenhauer E; AGO-OVAR; NCIC CTG; EORTC GCG. Gemcitabine plus carboplatin compared with carboplatin in patients with platinum-sensitive recurrent ovarian cancer: an intergroup trial of the AGO-OVAR, the NCIC CTG, and the EORTC GCG. J Clin Oncol. 2006 Oct 10;24(29):4699-707. Epub 2006 Sep 11. [http://jco.ascopubs.org/content/24/29/4699.long link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/16966687 PubMed] | ||
| − | ==Carboplatin | + | ==Carboplatin & Paclitaxel== |
| − | ===Regimen=== | + | ===Regimen, Parmar, et al. 2003 (ICON4/AGO-OVAR-2.2) & Pujade-Lauraine, et al. 2010=== |
| − | *[[Carboplatin (Paraplatin)]] AUC 5 | + | *[[Carboplatin (Paraplatin)]] AUC 5 to 6 IV once on day 1 |
| − | *[[Paclitaxel (Taxol)]] 175 | + | *[[Paclitaxel (Taxol)]] 175 to 185 mg/m2 IV over 3 hours once on day 1 |
'''21-day cycles''' | '''21-day cycles''' | ||
Supportive medications (varies depending on reference): | Supportive medications (varies depending on reference): | ||
| − | *Corticosteroids and prophylactic [[antiemesis|antiemetics]] with 5-HT3 antagonist | + | *[[Steroid conversions|Corticosteroids]] and prophylactic [[antiemesis|antiemetics]] with 5-HT3 antagonist |
*Premedication (with steroids & antihistamines) prior to paclitaxel | *Premedication (with steroids & antihistamines) prior to paclitaxel | ||
| Line 291: | Line 301: | ||
# Pujade-Lauraine E, Wagner U, Aavall-Lundqvist E, Gebski V, Heywood M, Vasey PA, Volgger B, Vergote I, Pignata S, Ferrero A, Sehouli J, Lortholary A, Kristensen G, Jackisch C, Joly F, Brown C, Le Fur N, du Bois A. Pegylated liposomal Doxorubicin and Carboplatin compared with Paclitaxel and Carboplatin for patients with platinum-sensitive ovarian cancer in late relapse. J Clin Oncol. 2010 Jul 10;28(20):3323-9. Epub 2010 May 24. [http://jco.ascopubs.org/content/28/20/3323.long link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/20498395 PubMed] | # Pujade-Lauraine E, Wagner U, Aavall-Lundqvist E, Gebski V, Heywood M, Vasey PA, Volgger B, Vergote I, Pignata S, Ferrero A, Sehouli J, Lortholary A, Kristensen G, Jackisch C, Joly F, Brown C, Le Fur N, du Bois A. Pegylated liposomal Doxorubicin and Carboplatin compared with Paclitaxel and Carboplatin for patients with platinum-sensitive ovarian cancer in late relapse. J Clin Oncol. 2010 Jul 10;28(20):3323-9. Epub 2010 May 24. [http://jco.ascopubs.org/content/28/20/3323.long link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/20498395 PubMed] | ||
| − | ==Cisplatin | + | ==Cisplatin & Gemcitabine== |
| − | ===Regimen=== | + | ===Regimen, Rose, et al. 2003=== |
| − | *[[Cisplatin (Platinol)]] 30 mg/m2 IV on days 1 & 8, given second | + | *[[Cisplatin (Platinol)]] 30 mg/m2 IV once per day on days 1 & 8, given second |
| − | *[[Gemcitabine (Gemzar)]] 750 mg/m2 IV over 30 minutes on days 1 & 8, given first | + | *[[Gemcitabine (Gemzar)]] 750 mg/m2 IV over 30 minutes once per day on days 1 & 8, given first |
'''21-day cycles''' | '''21-day cycles''' | ||
Supportive medications: | Supportive medications: | ||
| − | * | + | *[[Antiemesis|5-HT3 antagonists]] |
| − | *Corticosteroids | + | *[[Steroid conversions|Corticosteroids]] |
*Prochlorperazine | *Prochlorperazine | ||
*Magnesium supplementation with cisplatin | *Magnesium supplementation with cisplatin | ||
| Line 307: | Line 317: | ||
# Rose PG, Mossbruger K, Fusco N, Smrekar M, Eaton S, Rodriguez M. Gemcitabine reverses cisplatin resistance: demonstration of activity in platinum- and multidrug-resistant ovarian and peritoneal carcinoma. Gynecol Oncol. 2003 Jan;88(1):17-21. [http://www.sciencedirect.com/science/article/pii/S0090825802968502 link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/12504621 PubMed] | # Rose PG, Mossbruger K, Fusco N, Smrekar M, Eaton S, Rodriguez M. Gemcitabine reverses cisplatin resistance: demonstration of activity in platinum- and multidrug-resistant ovarian and peritoneal carcinoma. Gynecol Oncol. 2003 Jan;88(1):17-21. [http://www.sciencedirect.com/science/article/pii/S0090825802968502 link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/12504621 PubMed] | ||
| − | ==Cisplatin | + | ==Cisplatin & Paclitaxel== |
| − | ===Regimen=== | + | ===Regimen, Parmar, et al. 2003 (ICON4/AGO-OVAR-2.2)=== |
| − | *[[Cisplatin (Platinol)]] 50 mg/m2 IV on day 1 | + | *[[Cisplatin (Platinol)]] 50 mg/m2 IV once on day 1 |
| − | *[[Paclitaxel (Taxol)]] 175 mg/m2 IV over 3 hours on day 1 | + | *[[Paclitaxel (Taxol)]] 175 mg/m2 IV over 3 hours once on day 1 |
'''21-day cycles''' | '''21-day cycles''' | ||
| Line 318: | Line 328: | ||
==Docetaxel (Taxotere)== | ==Docetaxel (Taxotere)== | ||
| − | ===Regimen=== | + | ===Regimen, Rose, et al. 2003=== |
| − | *[[Docetaxel (Taxotere)]] 100 mg/m2 IV over 1 hour on day 1 | + | *[[Docetaxel (Taxotere)]] 100 mg/m2 IV over 1 hour once on day 1 |
'''21-day cycles''' | '''21-day cycles''' | ||
| Line 326: | Line 336: | ||
*[[Dexamethasone (Decadron)]] 8 mg PO BID starting 24 hours before docetaxel, and continuing for 48 hours after docetaxel | *[[Dexamethasone (Decadron)]] 8 mg PO BID starting 24 hours before docetaxel, and continuing for 48 hours after docetaxel | ||
*Diphenhydramine (Benadryl) 50 mg IV immediately prior to paclitaxel | *Diphenhydramine (Benadryl) 50 mg IV immediately prior to paclitaxel | ||
| − | *[[ | + | *[[Antiemesis|Antiemetics]] as needed |
===References=== | ===References=== | ||
| Line 333: | Line 343: | ||
==Doxorubicin liposomal (Doxil)== | ==Doxorubicin liposomal (Doxil)== | ||
===Regimen #1, Gordon, et al. 2004 & Mutch, et al. 2007=== | ===Regimen #1, Gordon, et al. 2004 & Mutch, et al. 2007=== | ||
| − | *[[Doxorubicin liposomal (Doxil)]] 50 mg/m2 IV over 60 minutes on day 1 | + | *[[Doxorubicin liposomal (Doxil)]] 50 mg/m2 IV over 60 minutes once on day 1 |
'''28-day cycles''' | '''28-day cycles''' | ||
===Regimen #2, Ferrandina, et al. 2008=== | ===Regimen #2, Ferrandina, et al. 2008=== | ||
| − | *[[Doxorubicin liposomal (Doxil)]] 40 mg/m2 IV over 60 minutes on day 1 | + | *[[Doxorubicin liposomal (Doxil)]] 40 mg/m2 IV over 60 minutes once on day 1 |
'''28-day cycles''' | '''28-day cycles''' | ||
Supportive medications: | Supportive medications: | ||
| − | *Methylprednisolone 20 mg IV 30 minutes prior to chemotherapy | + | *[[Methylprednisolone (Solumedrol)]] 20 mg IV once 30 minutes prior to chemotherapy |
===References=== | ===References=== | ||
| Line 350: | Line 360: | ||
# Ferrandina G, Ludovisi M, Lorusso D, Pignata S, Breda E, Savarese A, Del Medico P, Scaltriti L, Katsaros D, Priolo D, Scambia G. Phase III trial of gemcitabine compared with pegylated liposomal doxorubicin in progressive or recurrent ovarian cancer. J Clin Oncol. 2008 Feb 20;26(6):890-6. [http://jco.ascopubs.org/content/26/6/890.long link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/18281662 PubMed] | # Ferrandina G, Ludovisi M, Lorusso D, Pignata S, Breda E, Savarese A, Del Medico P, Scaltriti L, Katsaros D, Priolo D, Scambia G. Phase III trial of gemcitabine compared with pegylated liposomal doxorubicin in progressive or recurrent ovarian cancer. J Clin Oncol. 2008 Feb 20;26(6):890-6. [http://jco.ascopubs.org/content/26/6/890.long link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/18281662 PubMed] | ||
| − | ==Doxorubicin liposomal | + | ==Doxorubicin liposomal & Gemcitabine== |
| − | ===Regimen=== | + | ===Regimen, Ferrandina, et al. 2005=== |
| − | *[[Doxorubicin liposomal (Doxil)]] 30 mg/m2 IV over 60 minutes on day 1, given first | + | *[[Doxorubicin liposomal (Doxil)]] 30 mg/m2 IV over 60 minutes once on day 1, given first |
| − | *[[Gemcitabine (Gemzar)]] 1000 mg/m2 IV over 30 minutes on days 1 & 8 | + | *[[Gemcitabine (Gemzar)]] 1000 mg/m2 IV over 30 minutes once per day on days 1 & 8 |
'''21-day cycles''' | '''21-day cycles''' | ||
| Line 364: | Line 374: | ||
==Etoposide (Vepesid)== | ==Etoposide (Vepesid)== | ||
| − | ===Regimen=== | + | ===Regimen, Rose, et al. 1998=== |
| − | *[[Etoposide (Vepesid)]] 50 mg/m2 PO on days 1 | + | *[[Etoposide (Vepesid)]] 50 mg/m2 PO once per day on days 1 to 21 |
| − | **Dosage for patients with previous pelvic radiation was Etoposide (Vepesid) 30 mg/m2 PO on days 1 | + | **Dosage for patients with previous pelvic radiation was Etoposide (Vepesid) 30 mg/m2 PO once per day on days 1 to 21; dose could be increased up to 50 mg/m2 depending on toxicity |
'''28-day cycles''' | '''28-day cycles''' | ||
| Line 375: | Line 385: | ||
==Gemcitabine (Gemzar)== | ==Gemcitabine (Gemzar)== | ||
===Regimen #1, Mutch, et al. 2007=== | ===Regimen #1, Mutch, et al. 2007=== | ||
| − | *[[Gemcitabine (Gemzar)]] 1000 mg/m2 IV over 30 | + | *[[Gemcitabine (Gemzar)]] 1000 mg/m2 IV over 30 to 60 minutes once per day on days 1 & 8 |
'''21-day cycles''' | '''21-day cycles''' | ||
===Regimen #2, Ferrandina, et al. 2008=== | ===Regimen #2, Ferrandina, et al. 2008=== | ||
| − | *[[Gemcitabine (Gemzar)]] 1000 mg/m2 IV over 30 minutes on days 1, 8, 15 | + | *[[Gemcitabine (Gemzar)]] 1000 mg/m2 IV over 30 minutes once per day on days 1, 8, 15 |
'''28-day cycles''' | '''28-day cycles''' | ||
| Line 389: | Line 399: | ||
==Olaparib (AZD-2281)== | ==Olaparib (AZD-2281)== | ||
| − | ===Regimen=== | + | ===Regimen, Audeh, et al. 2010 & Gelmon, et al. 2011=== |
| − | *[[Olaparib (AZD-2281)]] 400 mg PO BID on days 1 | + | *[[Olaparib (AZD-2281)]] 400 mg PO BID on days 1 to 28 |
'''28-day cycles''' | '''28-day cycles''' | ||
| Line 399: | Line 409: | ||
==Paclitaxel (Taxol)== | ==Paclitaxel (Taxol)== | ||
| − | ===Regimen=== | + | ===Regimen, Gynecologic Oncology Group, et al. 2006=== |
| − | *[[Paclitaxel (Taxol)]] 80 mg/m2 IV over 1 hour on days 1, 8, 15, 22 | + | *[[Paclitaxel (Taxol)]] 80 mg/m2 IV over 1 hour once per day on days 1, 8, 15, 22 |
*Body surface area capped at 2 m2 | *Body surface area capped at 2 m2 | ||
| Line 406: | Line 416: | ||
Supportive medications: | Supportive medications: | ||
| − | *[[Dexamethasone (Decadron)]] 10 mg PO/IV 30 | + | *[[Dexamethasone (Decadron)]] 10 mg PO/IV once 30 to 60 minutes prior to paclitaxel |
| − | *Diphenhydramine (Benadryl) 25 | + | *Diphenhydramine (Benadryl) 25 to 50 mg IV once 30 to 60 minutes prior to paclitaxel |
| − | *H2 blocker 30 | + | *H2 blocker 30 to 60 minutes prior to paclitaxel |
===References=== | ===References=== | ||
# Gynecologic Oncology Group, Markman M, Blessing J, Rubin SC, Connor J, Hanjani P, Waggoner S. Phase II trial of weekly paclitaxel (80 mg/m2) in platinum and paclitaxel-resistant ovarian and primary peritoneal cancers: a Gynecologic Oncology Group study. Gynecol Oncol. 2006 Jun;101(3):436-40. Epub 2005 Dec 2. [http://www.sciencedirect.com/science/article/pii/S0090825805009765 link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/16325893 PubMed] | # Gynecologic Oncology Group, Markman M, Blessing J, Rubin SC, Connor J, Hanjani P, Waggoner S. Phase II trial of weekly paclitaxel (80 mg/m2) in platinum and paclitaxel-resistant ovarian and primary peritoneal cancers: a Gynecologic Oncology Group study. Gynecol Oncol. 2006 Jun;101(3):436-40. Epub 2005 Dec 2. [http://www.sciencedirect.com/science/article/pii/S0090825805009765 link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/16325893 PubMed] | ||
| − | ==Paclitaxel, nanoparticle albumin-bound (Abraxane | + | ==Paclitaxel, nanoparticle albumin-bound (Abraxane)== |
| − | ===Regimen=== | + | ===Regimen, Teneriello, et al. 2009=== |
| − | *[[Paclitaxel, nanoparticle albumin-bound (Abraxane)]] 260 mg/m2 IV over 30 minutes on day 1 | + | *[[Paclitaxel, nanoparticle albumin-bound (Abraxane)]] 260 mg/m2 IV over 30 minutes once on day 1 |
| − | '''21-day cycles x 6 | + | '''21-day cycles x 6 to 8 cycles''' |
===References=== | ===References=== | ||
# Teneriello MG, Tseng PC, Crozier M, Encarnacion C, Hancock K, Messing MJ, Boehm KA, Williams A, Asmar L. Phase II evaluation of nanoparticle albumin-bound paclitaxel in platinum-sensitive patients with recurrent ovarian, peritoneal, or fallopian tube cancer. J Clin Oncol. 2009 Mar 20;27(9):1426-31. Epub 2009 Feb 17. [http://jco.ascopubs.org/content/27/9/1426.long link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/19224848 PubMed] | # Teneriello MG, Tseng PC, Crozier M, Encarnacion C, Hancock K, Messing MJ, Boehm KA, Williams A, Asmar L. Phase II evaluation of nanoparticle albumin-bound paclitaxel in platinum-sensitive patients with recurrent ovarian, peritoneal, or fallopian tube cancer. J Clin Oncol. 2009 Mar 20;27(9):1426-31. Epub 2009 Feb 17. [http://jco.ascopubs.org/content/27/9/1426.long link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/19224848 PubMed] | ||
| + | |||
| + | ==Pazopanib (Votrient)== | ||
| + | ===Regimen, Friedlander, et al. 2010=== | ||
| + | *[[Pazopanib (Votrient)]] 800 mg PO once per day | ||
| + | |||
| + | '''given until progression of disease or unacceptable toxicity''' | ||
| + | |||
| + | ===References=== | ||
| + | # Friedlander M, Hancock KC, Rischin D, Messing MJ, Stringer CA, Matthys GM, Ma B, Hodge JP, Lager JJ. A Phase II, open-label study evaluating pazopanib in patients with recurrent ovarian cancer. Gynecol Oncol. 2010 Oct;119(1):32-7. doi: 10.1016/j.ygyno.2010.05.033. Epub 2010 Jun 27. [http://www.sciencedirect.com/science/article/pii/S0090825810004257 link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/20584542 PubMed] | ||
==Pemetrexed (Alimta)== | ==Pemetrexed (Alimta)== | ||
| − | ===Regimen=== | + | ===Regimen, Miller, et al. 2009=== |
| − | *[[Pemetrexed (Alimta)]] 900 mg/m2 IV over 10 minutes on day 1 | + | *[[Pemetrexed (Alimta)]] 900 mg/m2 IV over 10 minutes once on day 1 |
| − | **Dosage for patients with previous radiation therapy was Pemetrexed (Alimta) 700 mg/m2 | + | **Dosage for patients with previous radiation therapy was [[Pemetrexed (Alimta)]] 700 mg/m2 IV over 10 minutes once on day 1 |
'''21-day cycles''' | '''21-day cycles''' | ||
Supportive medications: | Supportive medications: | ||
| − | *Folic acid 350 | + | *Folic acid 350 to 600 mcg PO once per day, starting 7 days before pemetrexed, to continue throughout therapy |
| − | *[[Cyanocobalamin (Vitamin B12)]] 1000 mcg IM once 7 days before pemetrexed (then 1000 mcg to be given every 9 weeks thereafter) | + | *[[Cyanocobalamin (Vitamin B12)]] 1000 mcg IM once 7 days before pemetrexed (then 1000 mcg to be given once every 9 weeks thereafter) |
*[[Dexamethasone (Decadron)]] 4 mg PO BID the day before, the day of, and day after Pemetrexed (Alimta) | *[[Dexamethasone (Decadron)]] 4 mg PO BID the day before, the day of, and day after Pemetrexed (Alimta) | ||
*No NSAIDs (nonsteroidal anti-inflammatory drugs) for 2 days before or after pemetrexed | *No NSAIDs (nonsteroidal anti-inflammatory drugs) for 2 days before or after pemetrexed | ||
| Line 440: | Line 459: | ||
==Topotecan (Hycamtin)== | ==Topotecan (Hycamtin)== | ||
===Regimen #1, Gordon, et al. 2004=== | ===Regimen #1, Gordon, et al. 2004=== | ||
| − | *[[Topotecan (Hycamtin)]] 1.5 mg/m2 IV over 30 minutes on days 1 | + | *[[Topotecan (Hycamtin)]] 1.5 mg/m2 IV over 30 minutes once per day on days 1 to 5 |
'''21-day cycles''' | '''21-day cycles''' | ||
===Regimen #2, Sehouli, et al. 2011=== | ===Regimen #2, Sehouli, et al. 2011=== | ||
| − | *[[Topotecan (Hycamtin)]] 1.25 mg/m2 IV over 30 minutes on days 1 | + | *[[Topotecan (Hycamtin)]] 1.25 mg/m2 IV over 30 minutes once per day on days 1 to 5 |
'''21-day cycles x up to 12 months''' | '''21-day cycles x up to 12 months''' | ||
| − | ===Regimen #3 | + | ===Regimen #3, Sehouli, et al. 2011 (weekly topotecan)=== |
| − | *[[Topotecan (Hycamtin)]] 4 mg/m2 IV over 30 minutes on days 1, 8, 15 | + | *[[Topotecan (Hycamtin)]] 4 mg/m2 IV over 30 minutes once per day on days 1, 8, 15 |
'''28-day cycles x up to 12 months''' | '''28-day cycles x up to 12 months''' | ||
| Line 459: | Line 478: | ||
==Vinorelbine (Navelbine)== | ==Vinorelbine (Navelbine)== | ||
| − | ===Regimen=== | + | ===Regimen, Rothenberg, et al. 2004=== |
| − | *[[Vinorelbine (Navelbine)]] 30 mg/m2 IV on days 1 & 8 | + | *[[Vinorelbine (Navelbine)]] 30 mg/m2 IV once per day on days 1 & 8 |
'''21-day cycles''' | '''21-day cycles''' | ||
Revision as of 21:56, 1 June 2013
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Primary chemotherapy for advanced/metastatic disease
Carboplatin & Docetaxel
Regimen, Vasey, et al. 2004
- Carboplatin (Paraplatin) AUC 5 IV over 1 hour once on day 1, given second
- Docetaxel (Taxotere) 75 mg/m2 IV over 1 hour once on day 1, given first
21-day cycles x 6 cycles
Supportive medications:
- Dexamethasone (Decadron) 8 mg PO BID the day before, the day of, and day after docetaxel
- Ondansetron (Zofran) 8 mg or Granisetron (Kytril) 3 mg for antiemesis
References
- Vasey PA, Jayson GC, Gordon A, Gabra H, Coleman R, Atkinson R, Parkin D, Paul J, Hay A, Kaye SB; Scottish Gynaecological Cancer Trials Group. Phase III randomized trial of docetaxel-carboplatin versus paclitaxel-carboplatin as first-line chemotherapy for ovarian carcinoma. J Natl Cancer Inst. 2004 Nov 17;96(22):1682-91. link to original article contains verified protocol PubMed
Carboplatin & Gemcitabine
Regimen, Gordon, et al. 2011
- Carboplatin (Paraplatin) AUC 5 IV over 30 minutes once on day 1, given second
- Gemcitabine (Gemzar) 1000 mg/m2 IV 30 minutes once per day on days 1 & 8, given first
21-day cycles x up to 6 cycles; patients with complete response could optionally proceed to receive consolidation
Consolidation
- Paclitaxel (Taxol) 135 mg/m2 IV once on day 1
28-day cycles x up to 12 cycles
References
- Gordon AN, Teneriello M, Janicek MF, Hines J, Lim PC, Chen MD, Vaccarello L, Homesley HD, McMeekin S, Burkholder TL, Wang Y, Zhao L, Orlando M, Obasaju CK, Gill JF, Tai DF. Phase III trial of induction gemcitabine or paclitaxel plus carboplatin followed by paclitaxel consolidation in ovarian cancer. Gynecol Oncol. 2011 Dec;123(3):479-85. Epub 2011 Oct 5. link to original article contains verified protocol PubMed
Carboplatin & Paclitaxel
Regimen #1, Ozols, et al. 2003
- Carboplatin (Paraplatin) AUC 7.5 IV once on day 1
- Paclitaxel (Taxol) 175 mg/m2 IV over 3 hours once on day 1
21-day cycles x 6 cycles
Supportive medications:
- Dexamethasone (Decadron) 20 mg PO given twice, at 12 and 6 hours prior to chemotherapy OR 20 mg IV once 30 minutes prior to paclitaxel
- Diphenhydramine (Benadryl) 50 mg IV once 30 minutes prior to paclitaxel
- Cimetidine (Tagamet) 300 mg IV once 30 minutes prior to paclitaxel
Regimen #2, Vasey, et al. 2004
- Carboplatin (Paraplatin) AUC 5 IV over 1 hour once on day 1, given second
- Paclitaxel (Taxol) 175 mg/m2 IV over 3 hours once on day 1, given first
21-day cycles x 6 cycles
Supportive medications:
- Dexamethasone (Decadron) 20 mg PO given twice, at 12 and 6 hours prior to paclitaxel
- Diphenhydramine (Benadryl) 50 mg IV or chlorpheniramine 10 mg IV once 30 minutes prior to paclitaxel
- Ranitidine (Zantac) 50 mg IV or Cimetidine (Tagamet) 300 mg IV once 30 minutes prior to paclitaxel
- Ondansetron (Zofran) 8 mg or Granisetron (Kytril) 3 mg for antiemesis
Regimen #3, Katsumata, et al. 2009
- Carboplatin (Paraplatin) AUC 6 IV over 1 hour once on day 1
- Paclitaxel (Taxol) 180 mg/m2 IV over 3 hours once on day 1
21-day cycles x 6 to 9 cycles, depending on response
Supportive medications:
- "Standard premedication"
Regimen #4, Katsumata, et al. 2009 (weekly paclitaxel)
- Carboplatin (Paraplatin) AUC 6 IV over 1 hour once on day 1
- Paclitaxel (Taxol) 80 mg/m2 IV over 1 hour once per day on days 1, 8, 15
21-day cycles x 6 to 9 cycles, depending on response
Supportive medications:
- "Standard premedication"
Regimen #5, Gordon, et al. 2011
- Carboplatin (Paraplatin) AUC 6 IV over 30 minutes once on day 1
- Paclitaxel (Taxol) 175 mg/m2 IV over 3 hours once on day 1
21-day cycles x up to 6 cycles; patients with complete response could optionally proceed to receive consolidation
Consolidation
- Paclitaxel (Taxol) 135 mg/m2 IV once on day 1
28-day cycles x up to 12 cycles
Regimen #6, Burger, et al. 2011 & Perren, et al. 2011
- Carboplatin (Paraplatin) AUC 6 IV over 30 minutes once on day 1
- Paclitaxel (Taxol) 175 mg/m2 IV over 3 hours once on day 1
21-day cycles x 6 cycles
References
- Ozols RF, Bundy BN, Greer BE, Fowler JM, Clarke-Pearson D, Burger RA, Mannel RS, DeGeest K, Hartenbach EM, Baergen R; Gynecologic Oncology Group. Phase III trial of carboplatin and paclitaxel compared with cisplatin and paclitaxel in patients with optimally resected stage III ovarian cancer: a Gynecologic Oncology Group study. J Clin Oncol. 2003 Sep 1;21(17):3194-200. Epub 2003 Jul 14. link to original article contains verified protocol PubMed
- Vasey PA, Jayson GC, Gordon A, Gabra H, Coleman R, Atkinson R, Parkin D, Paul J, Hay A, Kaye SB; Scottish Gynaecological Cancer Trials Group. Phase III randomized trial of docetaxel-carboplatin versus paclitaxel-carboplatin as first-line chemotherapy for ovarian carcinoma. J Natl Cancer Inst. 2004 Nov 17;96(22):1682-91. link to original article contains verified protocol PubMed
- Katsumata N, Yasuda M, Takahashi F, Isonishi S, Jobo T, Aoki D, Tsuda H, Sugiyama T, Kodama S, Kimura E, Ochiai K, Noda K; Japanese Gynecologic Oncology Group. Dose-dense paclitaxel once a week in combination with carboplatin every 3 weeks for advanced ovarian cancer: a phase 3, open-label, randomised controlled trial. Lancet. 2009 Oct 17;374(9698):1331-8. Epub 2009 Sep 18. link to original article contains verified protocol PubMed
- Gordon AN, Teneriello M, Janicek MF, Hines J, Lim PC, Chen MD, Vaccarello L, Homesley HD, McMeekin S, Burkholder TL, Wang Y, Zhao L, Orlando M, Obasaju CK, Gill JF, Tai DF. Phase III trial of induction gemcitabine or paclitaxel plus carboplatin followed by paclitaxel consolidation in ovarian cancer. Gynecol Oncol. 2011 Dec;123(3):479-85. Epub 2011 Oct 5. link to original article contains verified protocol PubMed
- Burger RA, Brady MF, Bookman MA, Fleming GF, Monk BJ, Huang H, Mannel RS, Homesley HD, Fowler J, Greer BE, Boente M, Birrer MJ, Liang SX; Gynecologic Oncology Group. Incorporation of bevacizumab in the primary treatment of ovarian cancer. N Engl J Med. 2011 Dec 29;365(26):2473-83. link to original article contains verified protocol PubMed
- Perren TJ, Swart AM, Pfisterer J, Ledermann JA, Pujade-Lauraine E, Kristensen G, Carey MS, Beale P, Cervantes A, Kurzeder C, du Bois A, Sehouli J, Kimmig R, Stähle A, Collinson F, Essapen S, Gourley C, Lortholary A, Selle F, Mirza MR, Leminen A, Plante M, Stark D, Qian W, Parmar MK, Oza AM; ICON7 Investigators. A phase 3 trial of bevacizumab in ovarian cancer. N Engl J Med. 2011 Dec 29;365(26):2484-96. link to original article contains verified protocol PubMed
Carboplatin, Paclitaxel, Bevacizumab
Regimen #1, Burger, et al. 2011 (GOG-0218)
- Carboplatin (Paraplatin) AUC 6 IV over 30 minutes once on day 1
- Paclitaxel (Taxol) 175 mg/m2 IV over 3 hours once on day 1
21-day cycle x 1 cycle, then
- Carboplatin (Paraplatin) AUC 6 IV over 30 minutes once on day 1
- Paclitaxel (Taxol) 175 mg/m2 IV over 3 hours once on day 1
- Bevacizumab (Avastin) 15 mg/kg IV once on day 1
21-day cycles x 5 cycles, then
- Bevacizumab (Avastin) 15 mg/kg IV once on day 1
21-day cycles x up to 16 cycles
Regimen #2, Perren, et al. 2011 (ICON7)
- Carboplatin (Paraplatin) AUC 5 to 6 IV over 30 to 60 minutes once on day 1; the protocol linked from Perren, et al. 2011 clarifies that the recommended dose was AUC 6, but that it could be adjusted "according to standard practice"
- Paclitaxel (Taxol) 175 mg/m2 IV over 3 hours once on day 1
- Bevacizumab is not given in cycle 1 if chemotherapy starts within 4 weeks of surgery. If >4 weeks after surgery: Bevacizumab (Avastin) 7.5 mg/kg IV once on day 1
21-day cycle x 1 cycle, then
- Carboplatin (Paraplatin) AUC 5 to 6 IV over 30 to 60 minutes once on day 1
- Paclitaxel (Taxol) 175 mg/m2 IV over 3 hours once on day 1
- Bevacizumab (Avastin) 7.5 mg/kg IV once on day 1
21-day cycles x 5 cycles, then
- Bevacizumab (Avastin) 15 mg/kg IV once on day 1
21-day cycles x 12 cycles
References
- Burger RA, Brady MF, Bookman MA, Fleming GF, Monk BJ, Huang H, Mannel RS, Homesley HD, Fowler J, Greer BE, Boente M, Birrer MJ, Liang SX; Gynecologic Oncology Group. Incorporation of bevacizumab in the primary treatment of ovarian cancer. N Engl J Med. 2011 Dec 29;365(26):2473-83. link to original article contains verified protocol PubMed
- Perren TJ, Swart AM, Pfisterer J, Ledermann JA, Pujade-Lauraine E, Kristensen G, Carey MS, Beale P, Cervantes A, Kurzeder C, du Bois A, Sehouli J, Kimmig R, Stähle A, Collinson F, Essapen S, Gourley C, Lortholary A, Selle F, Mirza MR, Leminen A, Plante M, Stark D, Qian W, Parmar MK, Oza AM; ICON7 Investigators. A phase 3 trial of bevacizumab in ovarian cancer. N Engl J Med. 2011 Dec 29;365(26):2484-96. link to original article contains verified protocol PubMed
Cisplatin & Paclitaxel
Regimen, Ozols, et al. 2003; Armstrong, et al. 2006; Walker, et al. 2006
- Cisplatin (Platinol) 75 mg/m2 IV at an infusion rate of 1 mg/min once on day 1
- Paclitaxel (Taxol) 135 mg/m2 IV continuous infusion over 24 hours once on day 1
21-day cycles x 6 cycles
Supportive medications (details vary depending on reference):
- Dexamethasone (Decadron) 20 mg PO given twice, at 12 and 6 hours prior to chemotherapy OR 20 mg IV once 30 minutes prior to paclitaxel
- Diphenhydramine (Benadryl) 50 mg IV once 30 minutes prior to paclitaxel
- Cimetidine (Tagamet) 300 mg IV once 30 minutes prior to paclitaxel
- "Hydration and antiemetic agents" before cisplatin
References
- Ozols RF, Bundy BN, Greer BE, Fowler JM, Clarke-Pearson D, Burger RA, Mannel RS, DeGeest K, Hartenbach EM, Baergen R; Gynecologic Oncology Group. Phase III trial of carboplatin and paclitaxel compared with cisplatin and paclitaxel in patients with optimally resected stage III ovarian cancer: a Gynecologic Oncology Group study. J Clin Oncol. 2003 Sep 1;21(17):3194-200. Epub 2003 Jul 14. link to original article contains verified protocol PubMed
- Armstrong DK, Bundy B, Wenzel L, Huang HQ, Baergen R, Lele S, Copeland LJ, Walker JL, Burger RA; Gynecologic Oncology Group. Intraperitoneal cisplatin and paclitaxel in ovarian cancer. N Engl J Med. 2006 Jan 5;354(1):34-43. link to original article contains verified protocol PubMed
- Walker JL, Armstrong DK, Huang HQ, Fowler J, Webster K, Burger RA, Clarke-Pearson D. Intraperitoneal catheter outcomes in a phase III trial of intravenous versus intraperitoneal chemotherapy in optimal stage III ovarian and primary peritoneal cancer: a Gynecologic Oncology Group Study. Gynecol Oncol. 2006 Jan;100(1):27-32. link to original article contains verified protocol PubMed
Maintenance/consolidation therapy
Altretamine (Hexalen)
Regimen, Alberts, et al. 2004
- Altretamine (Hexalen) 260 mg/m2 PO once per day on days 1 to 14
28-day cycles
References
- Alberts DS, Jiang C, Liu PY, Wilczynski S, Markman M, Rothenberg ML. Long-term follow-up of a phase II trial of oral altretamine for consolidation of clinical complete remission in women with stage III epithelial ovarian cancer in the Southwest Oncology Group. Int J Gynecol Cancer. 2004 Mar-Apr;14(2):224-8. PubMed
Paclitaxel (Taxol)
Regimen #1, Markman, et al. 2003 & Markman, et al. 2009
- Paclitaxel (Taxol) 135 or 175 mg/m2 IV over 3 hours once on day 1
28-day cycles x 12 cycles
Regimen #2, Micha, et al. 2005 & Abaid, et al. 2010
- Paclitaxel (Taxol) 135 mg/m2 IV over 1 hour once on day 1
21-day cycles x 12 cycles
Supportive medications:
- Diphenhydramine (Benadryl), Dexamethasone (Decadron), Cimetidine (Tagamet)
References
- Markman M, Liu PY, Wilczynski S, Monk B, Copeland LJ, Alvarez RD, Jiang C, Alberts D; Southwest Oncology Group; Gynecologic Oncology Group. Phase III randomized trial of 12 versus 3 months of maintenance paclitaxel in patients with advanced ovarian cancer after complete response to platinum and paclitaxel-based chemotherapy: a Southwest Oncology Group and Gynecologic Oncology Group trial. J Clin Oncol. 2003 Jul 1;21(13):2460-5. link to original article contains verified protocol PubMed
- Micha JP, Goldstein BH, Mattison JA, Bader K, Graham C, Rettenmaier MA, Brown JV, Markman M. Experience with single-agent paclitaxel consolidation following primary chemotherapy with carboplatin, paclitaxel, and gemcitabine in advanced ovarian cancer. Gynecol Oncol. 2005 Jan;96(1):132-5. link to original article contains verified protocol PubMed
- Markman M, Liu PY, Moon J, Monk BJ, Copeland L, Wilczynski S, Alberts D. Impact on survival of 12 versus 3 monthly cycles of paclitaxel (175 mg/m2) administered to patients with advanced ovarian cancer who attained a complete response to primary platinum-paclitaxel: follow-up of a Southwest Oncology Group and Gynecologic Oncology Group phase 3 trial. Gynecol Oncol. 2009 Aug;114(2):195-8. Epub 2009 May 17. link to original article contains verified protocol PubMed
- Abaid LN, Goldstein BH, Micha JP, Rettenmaier MA, Brown JV 3rd, Markman M. Improved overall survival with 12 cycles of single-agent paclitaxel maintenance therapy following a complete response to induction chemotherapy in advanced ovarian carcinoma. Oncology. 2010;78(5-6):389-93. Epub 2010 Aug 27. link to original article contains verified protocol PubMed
Pazopanib (Votrient)
Regimen, Du Bois, et al. 2013 (AGO-OVAR16)
Patients enrolled in Du Bois, et al. 2013 (AGO-OVAR16) had histologically confirmed advanced epithelial ovarian, fallopian tube, or primary peritoneal cancer, were FIGO II to IV, and no evidence of progression after surgery and at least 5 cycles of platinum-taxane chemotherapy.
- Pazopanib (Votrient) 800 mg PO once per day
24-month course
References
- Andreas Du Bois, Anne Floquet, Jae Weon Kim, Jörn Rau, Jose Maria Del Campo, Michael Friedlander, Sandro Pignata, Keiichi Fujiwara, Ignace Vergote, Nicoletta Colombo, Mansoor Raza Mirza, Bradley J. Monk, Pauline Wimberger, Isabelle Ray-Coquard, Rongyu Zang, Ivan Diaz-Padilla, Klaus H. Baumann, Jae Hoon Kim, Philipp Harter. Randomized, double-blind, phase III trial of pazopanib versus placebo in women who have not progressed after first-line chemotherapy for advanced epithelial ovarian, fallopian tube, or primary peritoneal cancer (AEOC): Results of an international Intergroup trial (AGO-OVAR16). 2013 ASCO Annual Meeting abstract LBA5503. link to abstract
Intraperitoneal therapy
Cisplatin & Paclitaxel
Regimen #1, Armstrong, et al. 2006
- Cisplatin (Platinol) 100 mg/m2 intraperitoneal rapid infusion once on day 2
- Paclitaxel (Taxol) 135 mg/m2 IV continuous infusion over 24 hours once on day 1, then 60 mg/m2 intraperitoneal rapid infusion once on day 8
21-day cycles x 6 cycles
Supportive medications:
- "Standard premedication" for paclitaxel
- "Hydration and antiemetic agents" before cisplatin
- Intraperitoneal doses of cisplatin and paclitaxel are reconstituted in 2 liters of warm normal saline before infusion
Regimen #2, Walker, et al. 2006
- Cisplatin (Platinol) 100 mg/m2 in 2 liters of normal saline, intraperitoneal rapid infusion once on day 2, with patient rolled onto 4 different positions every 15 minutes to evenly distribute cisplatin
- Paclitaxel (Taxol) 135 mg/m2 IV continuous infusion over 24 hours once on day 1, then 60 mg/m2 in 1 liter saline, intraperitoneal rapid infusion once on day 8
21-day cycles x 6 cycles
Supportive medications:
- Additional 1 liter normal saline to be infused immediately after intraperitoneal paclitaxel
- Supportive medications left to investigator discretion
References
- Armstrong DK, Bundy B, Wenzel L, Huang HQ, Baergen R, Lele S, Copeland LJ, Walker JL, Burger RA; Gynecologic Oncology Group. Intraperitoneal cisplatin and paclitaxel in ovarian cancer. N Engl J Med. 2006 Jan 5;354(1):34-43. link to original article contains verified protocol PubMed
- Walker JL, Armstrong DK, Huang HQ, Fowler J, Webster K, Burger RA, Clarke-Pearson D. Intraperitoneal catheter outcomes in a phase III trial of intravenous versus intraperitoneal chemotherapy in optimal stage III ovarian and primary peritoneal cancer: a Gynecologic Oncology Group Study. Gynecol Oncol. 2006 Jan;100(1):27-32. link to original article contains verified protocol PubMed
Relapsed or recurrent disease
Carboplatin (Paraplatin)
Regimen
- Carboplatin (Paraplatin) AUC 5 IV once on day 1
21-day cycles x 6 to 10 cycles
References
- Pfisterer J, Plante M, Vergote I, du Bois A, Hirte H, Lacave AJ, Wagner U, Stähle A, Stuart G, Kimmig R, Olbricht S, Le T, Emerich J, Kuhn W, Bentley J, Jackisch C, Lück HJ, Rochon J, Zimmermann AH, Eisenhauer E; AGO-OVAR; NCIC CTG; EORTC GCG. Gemcitabine plus carboplatin compared with carboplatin in patients with platinum-sensitive recurrent ovarian cancer: an intergroup trial of the AGO-OVAR, the NCIC CTG, and the EORTC GCG. J Clin Oncol. 2006 Oct 10;24(29):4699-707. Epub 2006 Sep 11. link to original article contains verified protocol PubMed
Carboplatin & Docetaxel
Regimen #1, Strauss, et al. 2007
- Carboplatin (Paraplatin) AUC 5 IV over 30 to 60 minutes once on day 1, given second
- Docetaxel (Taxotere) 75 mg/m2 IV over 60 minutes once on day 1, given first
21-day cycles x 6 cycles
Supportive medications:
- Corticosteroids given twice, 12 hours and 30 minutes before docetaxel
- Prophylactic antiemetics with 5-HT3 antagonist
Regimen #2, Kushner, et al. 2007
- Carboplatin (Paraplatin) AUC 2 IV over 30 minutes once per day on days 1, 8, 15, given second
- Docetaxel (Taxotere) 35 mg/m2 IV over 60 minutes once per day on days 1, 8, 15, given first
- Body surface area capped at 2 m2
28-day cycles x 6 cycles
Supportive medications:
- Dexamethasone (Decadron) 4 mg PO the evening before, the morning of, and evening after docetaxel
- 5-HT3 antagonist before chemotherapy
- Phenothiazine or 5-HT3 antagonist as needed as an outpatient
- Diphenhydramine (Benadryl) 50 mg IV once immediately prior to docetaxel
References
- Strauss HG, Henze A, Teichmann A, Karbe I, Baumgart A, Thomssen C, Koelbl H. Phase II trial of docetaxel and carboplatin in recurrent platinum-sensitive ovarian, peritoneal and tubal cancer. Gynecol Oncol. 2007 Mar;104(3):612-6. Epub 2006 Oct 27. link to original article contains verified protocol PubMed
- Kushner DM, Connor JP, Sanchez F, Volk M, Schink JC, Bailey HH, Harris LS, Stewart SL, Fine J, Hartenbach EM; Wisconsin Oncology Network. Weekly docetaxel and carboplatin for recurrent ovarian and peritoneal cancer: a phase II trial. Gynecol Oncol. 2007 May;105(2):358-64. Epub 2007 Jan 29. link to original article contains verified protocol PubMed
Carboplatin & Doxorubicin liposomal
Regimen, Pujade-Lauraine, et al. 2010
- Carboplatin (Paraplatin) AUC 5 IV once on day 1
- Doxorubicin liposomal (Doxil) 30 mg/m2 IV once on day 1
28-day cycles x 6 or more cycles, depending on response and toxicity
Supportive medications (varies depending on reference):
- Corticosteroids and prophylactic antiemetics with 5-HT3 antagonist
References
- Pujade-Lauraine E, Wagner U, Aavall-Lundqvist E, Gebski V, Heywood M, Vasey PA, Volgger B, Vergote I, Pignata S, Ferrero A, Sehouli J, Lortholary A, Kristensen G, Jackisch C, Joly F, Brown C, Le Fur N, du Bois A. Pegylated liposomal Doxorubicin and Carboplatin compared with Paclitaxel and Carboplatin for patients with platinum-sensitive ovarian cancer in late relapse. J Clin Oncol. 2010 Jul 10;28(20):3323-9. Epub 2010 May 24. link to original article contains verified protocol PubMed
Carboplatin & Gemcitabine
Regimen, Pfisterer, et al. 2006
- Carboplatin (Paraplatin) AUC 4 IV once on day 1
- Gemcitabine (Gemzar) 1000 mg/m2 IV once per day on days 1 & 8
21-day cycles x 6 to 10 cycles
References
- Pfisterer J, Plante M, Vergote I, du Bois A, Hirte H, Lacave AJ, Wagner U, Stähle A, Stuart G, Kimmig R, Olbricht S, Le T, Emerich J, Kuhn W, Bentley J, Jackisch C, Lück HJ, Rochon J, Zimmermann AH, Eisenhauer E; AGO-OVAR; NCIC CTG; EORTC GCG. Gemcitabine plus carboplatin compared with carboplatin in patients with platinum-sensitive recurrent ovarian cancer: an intergroup trial of the AGO-OVAR, the NCIC CTG, and the EORTC GCG. J Clin Oncol. 2006 Oct 10;24(29):4699-707. Epub 2006 Sep 11. link to original article contains verified protocol PubMed
Carboplatin & Paclitaxel
Regimen, Parmar, et al. 2003 (ICON4/AGO-OVAR-2.2) & Pujade-Lauraine, et al. 2010
- Carboplatin (Paraplatin) AUC 5 to 6 IV once on day 1
- Paclitaxel (Taxol) 175 to 185 mg/m2 IV over 3 hours once on day 1
21-day cycles
Supportive medications (varies depending on reference):
- Corticosteroids and prophylactic antiemetics with 5-HT3 antagonist
- Premedication (with steroids & antihistamines) prior to paclitaxel
References
- Parmar MK, Ledermann JA, Colombo N, du Bois A, Delaloye JF, Kristensen GB, Wheeler S, Swart AM, Qian W, Torri V, Floriani I, Jayson G, Lamont A, Tropé C; ICON and AGO Collaborators. Paclitaxel plus platinum-based chemotherapy versus conventional platinum-based chemotherapy in women with relapsed ovarian cancer: the ICON4/AGO-OVAR-2.2 trial. Lancet. 2003 Jun 21;361(9375):2099-106. link to original article contains verified protocol PubMed
- Pujade-Lauraine E, Wagner U, Aavall-Lundqvist E, Gebski V, Heywood M, Vasey PA, Volgger B, Vergote I, Pignata S, Ferrero A, Sehouli J, Lortholary A, Kristensen G, Jackisch C, Joly F, Brown C, Le Fur N, du Bois A. Pegylated liposomal Doxorubicin and Carboplatin compared with Paclitaxel and Carboplatin for patients with platinum-sensitive ovarian cancer in late relapse. J Clin Oncol. 2010 Jul 10;28(20):3323-9. Epub 2010 May 24. link to original article contains verified protocol PubMed
Cisplatin & Gemcitabine
Regimen, Rose, et al. 2003
- Cisplatin (Platinol) 30 mg/m2 IV once per day on days 1 & 8, given second
- Gemcitabine (Gemzar) 750 mg/m2 IV over 30 minutes once per day on days 1 & 8, given first
21-day cycles
Supportive medications:
- 5-HT3 antagonists
- Corticosteroids
- Prochlorperazine
- Magnesium supplementation with cisplatin
References
- Rose PG, Mossbruger K, Fusco N, Smrekar M, Eaton S, Rodriguez M. Gemcitabine reverses cisplatin resistance: demonstration of activity in platinum- and multidrug-resistant ovarian and peritoneal carcinoma. Gynecol Oncol. 2003 Jan;88(1):17-21. link to original article contains verified protocol PubMed
Cisplatin & Paclitaxel
Regimen, Parmar, et al. 2003 (ICON4/AGO-OVAR-2.2)
- Cisplatin (Platinol) 50 mg/m2 IV once on day 1
- Paclitaxel (Taxol) 175 mg/m2 IV over 3 hours once on day 1
21-day cycles
References
- Parmar MK, Ledermann JA, Colombo N, du Bois A, Delaloye JF, Kristensen GB, Wheeler S, Swart AM, Qian W, Torri V, Floriani I, Jayson G, Lamont A, Tropé C; ICON and AGO Collaborators. Paclitaxel plus platinum-based chemotherapy versus conventional platinum-based chemotherapy in women with relapsed ovarian cancer: the ICON4/AGO-OVAR-2.2 trial. Lancet. 2003 Jun 21;361(9375):2099-106. link to original article contains verified protocol PubMed
Docetaxel (Taxotere)
Regimen, Rose, et al. 2003
- Docetaxel (Taxotere) 100 mg/m2 IV over 1 hour once on day 1
21-day cycles
Supportive medications:
- Dexamethasone (Decadron) 8 mg PO BID starting 24 hours before docetaxel, and continuing for 48 hours after docetaxel
- Diphenhydramine (Benadryl) 50 mg IV immediately prior to paclitaxel
- Antiemetics as needed
References
- Rose PG, Blessing JA, Ball HG, Hoffman J, Warshal D, DeGeest K, Moore DH. A phase II study of docetaxel in paclitaxel-resistant ovarian and peritoneal carcinoma: a Gynecologic Oncology Group study. Gynecol Oncol. 2003 Feb;88(2):130-5. link to original article contains verified protocol PubMed
Doxorubicin liposomal (Doxil)
Regimen #1, Gordon, et al. 2004 & Mutch, et al. 2007
- Doxorubicin liposomal (Doxil) 50 mg/m2 IV over 60 minutes once on day 1
28-day cycles
Regimen #2, Ferrandina, et al. 2008
- Doxorubicin liposomal (Doxil) 40 mg/m2 IV over 60 minutes once on day 1
28-day cycles
Supportive medications:
- Methylprednisolone (Solumedrol) 20 mg IV once 30 minutes prior to chemotherapy
References
- Gordon AN, Tonda M, Sun S, Rackoff W; Doxil Study 30-49 Investigators. Long-term survival advantage for women treated with pegylated liposomal doxorubicin compared with topotecan in a phase 3 randomized study of recurrent and refractory epithelial ovarian cancer. Gynecol Oncol. 2004 Oct;95(1):1-8. link to original article contains verified protocol PubMed
- Mutch DG, Orlando M, Goss T, Teneriello MG, Gordon AN, McMeekin SD, Wang Y, Scribner DR Jr, Marciniack M, Naumann RW, Secord AA. Randomized phase III trial of gemcitabine compared with pegylated liposomal doxorubicin in patients with platinum-resistant ovarian cancer. J Clin Oncol. 2007 Jul 1;25(19):2811-8. link to original article contains verified protocol PubMed content property of HemOnc.org
- Ferrandina G, Ludovisi M, Lorusso D, Pignata S, Breda E, Savarese A, Del Medico P, Scaltriti L, Katsaros D, Priolo D, Scambia G. Phase III trial of gemcitabine compared with pegylated liposomal doxorubicin in progressive or recurrent ovarian cancer. J Clin Oncol. 2008 Feb 20;26(6):890-6. link to original article contains verified protocol PubMed
Doxorubicin liposomal & Gemcitabine
Regimen, Ferrandina, et al. 2005
- Doxorubicin liposomal (Doxil) 30 mg/m2 IV over 60 minutes once on day 1, given first
- Gemcitabine (Gemzar) 1000 mg/m2 IV over 30 minutes once per day on days 1 & 8
21-day cycles
Supportive medications:
- Metoclopramide (Reglan) before chemotherapy
References
- Ferrandina G, Paris I, Ludovisi M, D'Agostino G, Testa A, Lorusso D, Zanghi M, Pisconti S, Pezzella G, Adamo V, Breda E, Scambia G. Gemcitabine and liposomal doxorubicin in the salvage treatment of ovarian cancer: updated results and long-term survival. Gynecol Oncol. 2005 Aug;98(2):267-73. link to original article contains verified protocol PubMed
Etoposide (Vepesid)
Regimen, Rose, et al. 1998
- Etoposide (Vepesid) 50 mg/m2 PO once per day on days 1 to 21
- Dosage for patients with previous pelvic radiation was Etoposide (Vepesid) 30 mg/m2 PO once per day on days 1 to 21; dose could be increased up to 50 mg/m2 depending on toxicity
28-day cycles
References
- Rose PG, Blessing JA, Mayer AR, Homesley HD. Prolonged oral etoposide as second-line therapy for platinum-resistant and platinum-sensitive ovarian carcinoma: a Gynecologic Oncology Group study. J Clin Oncol. 1998 Feb;16(2):405-10. link to original article contains verified protocol PubMed
Gemcitabine (Gemzar)
Regimen #1, Mutch, et al. 2007
- Gemcitabine (Gemzar) 1000 mg/m2 IV over 30 to 60 minutes once per day on days 1 & 8
21-day cycles
Regimen #2, Ferrandina, et al. 2008
- Gemcitabine (Gemzar) 1000 mg/m2 IV over 30 minutes once per day on days 1, 8, 15
28-day cycles
References
- Mutch DG, Orlando M, Goss T, Teneriello MG, Gordon AN, McMeekin SD, Wang Y, Scribner DR Jr, Marciniack M, Naumann RW, Secord AA. Randomized phase III trial of gemcitabine compared with pegylated liposomal doxorubicin in patients with platinum-resistant ovarian cancer. J Clin Oncol. 2007 Jul 1;25(19):2811-8. link to original article contains verified protocol PubMed
- Ferrandina G, Ludovisi M, Lorusso D, Pignata S, Breda E, Savarese A, Del Medico P, Scaltriti L, Katsaros D, Priolo D, Scambia G. Phase III trial of gemcitabine compared with pegylated liposomal doxorubicin in progressive or recurrent ovarian cancer. J Clin Oncol. 2008 Feb 20;26(6):890-6. link to original article contains verified protocol PubMed
Olaparib (AZD-2281)
Regimen, Audeh, et al. 2010 & Gelmon, et al. 2011
- Olaparib (AZD-2281) 400 mg PO BID on days 1 to 28
28-day cycles
References
- Audeh MW, Carmichael J, Penson RT, Friedlander M, Powell B, Bell-McGuinn KM, Scott C, Weitzel JN, Oaknin A, Loman N, Lu K, Schmutzler RK, Matulonis U, Wickens M, Tutt A. Oral poly(ADP-ribose) polymerase inhibitor olaparib in patients with BRCA1 or BRCA2 mutations and recurrent ovarian cancer: a proof-of-concept trial. Lancet. 2010 Jul 24;376(9737):245-51. Epub 2010 Jul 6. link to original article contains verified protocol PubMed
- Gelmon KA, Tischkowitz M, Mackay H, Swenerton K, Robidoux A, Tonkin K, Hirte H, Huntsman D, Clemons M, Gilks B, Yerushalmi R, Macpherson E, Carmichael J, Oza A. Olaparib in patients with recurrent high-grade serous or poorly differentiated ovarian carcinoma or triple-negative breast cancer: a phase 2, multicentre, open-label, non-randomised study. Lancet Oncol. 2011 Sep;12(9):852-61. Epub 2011 Aug 19. link to original article contains verified protocol PubMed
Paclitaxel (Taxol)
Regimen, Gynecologic Oncology Group, et al. 2006
- Paclitaxel (Taxol) 80 mg/m2 IV over 1 hour once per day on days 1, 8, 15, 22
- Body surface area capped at 2 m2
28-day cycles
Supportive medications:
- Dexamethasone (Decadron) 10 mg PO/IV once 30 to 60 minutes prior to paclitaxel
- Diphenhydramine (Benadryl) 25 to 50 mg IV once 30 to 60 minutes prior to paclitaxel
- H2 blocker 30 to 60 minutes prior to paclitaxel
References
- Gynecologic Oncology Group, Markman M, Blessing J, Rubin SC, Connor J, Hanjani P, Waggoner S. Phase II trial of weekly paclitaxel (80 mg/m2) in platinum and paclitaxel-resistant ovarian and primary peritoneal cancers: a Gynecologic Oncology Group study. Gynecol Oncol. 2006 Jun;101(3):436-40. Epub 2005 Dec 2. link to original article contains verified protocol PubMed
Paclitaxel, nanoparticle albumin-bound (Abraxane)
Regimen, Teneriello, et al. 2009
- Paclitaxel, nanoparticle albumin-bound (Abraxane) 260 mg/m2 IV over 30 minutes once on day 1
21-day cycles x 6 to 8 cycles
References
- Teneriello MG, Tseng PC, Crozier M, Encarnacion C, Hancock K, Messing MJ, Boehm KA, Williams A, Asmar L. Phase II evaluation of nanoparticle albumin-bound paclitaxel in platinum-sensitive patients with recurrent ovarian, peritoneal, or fallopian tube cancer. J Clin Oncol. 2009 Mar 20;27(9):1426-31. Epub 2009 Feb 17. link to original article contains verified protocol PubMed
Pazopanib (Votrient)
Regimen, Friedlander, et al. 2010
- Pazopanib (Votrient) 800 mg PO once per day
given until progression of disease or unacceptable toxicity
References
- Friedlander M, Hancock KC, Rischin D, Messing MJ, Stringer CA, Matthys GM, Ma B, Hodge JP, Lager JJ. A Phase II, open-label study evaluating pazopanib in patients with recurrent ovarian cancer. Gynecol Oncol. 2010 Oct;119(1):32-7. doi: 10.1016/j.ygyno.2010.05.033. Epub 2010 Jun 27. link to original article contains verified protocol PubMed
Pemetrexed (Alimta)
Regimen, Miller, et al. 2009
- Pemetrexed (Alimta) 900 mg/m2 IV over 10 minutes once on day 1
- Dosage for patients with previous radiation therapy was Pemetrexed (Alimta) 700 mg/m2 IV over 10 minutes once on day 1
21-day cycles
Supportive medications:
- Folic acid 350 to 600 mcg PO once per day, starting 7 days before pemetrexed, to continue throughout therapy
- Cyanocobalamin (Vitamin B12) 1000 mcg IM once 7 days before pemetrexed (then 1000 mcg to be given once every 9 weeks thereafter)
- Dexamethasone (Decadron) 4 mg PO BID the day before, the day of, and day after Pemetrexed (Alimta)
- No NSAIDs (nonsteroidal anti-inflammatory drugs) for 2 days before or after pemetrexed
References
- Miller DS, Blessing JA, Krasner CN, Mannel RS, Hanjani P, Pearl ML, Waggoner SE, Boardman CH. Phase II evaluation of pemetrexed in the treatment of recurrent or persistent platinum-resistant ovarian or primary peritoneal carcinoma: a study of the Gynecologic Oncology Group. J Clin Oncol. 2009 Jun 1;27(16):2686-91. Epub 2009 Mar 30. link to original article contains verified protocol PubMed
Topotecan (Hycamtin)
Regimen #1, Gordon, et al. 2004
- Topotecan (Hycamtin) 1.5 mg/m2 IV over 30 minutes once per day on days 1 to 5
21-day cycles
Regimen #2, Sehouli, et al. 2011
- Topotecan (Hycamtin) 1.25 mg/m2 IV over 30 minutes once per day on days 1 to 5
21-day cycles x up to 12 months
Regimen #3, Sehouli, et al. 2011 (weekly topotecan)
- Topotecan (Hycamtin) 4 mg/m2 IV over 30 minutes once per day on days 1, 8, 15
28-day cycles x up to 12 months
References
- Gordon AN, Tonda M, Sun S, Rackoff W; Doxil Study 30-49 Investigators. Long-term survival advantage for women treated with pegylated liposomal doxorubicin compared with topotecan in a phase 3 randomized study of recurrent and refractory epithelial ovarian cancer. Gynecol Oncol. 2004 Oct;95(1):1-8. link to original article contains verified protocol PubMed
- Sehouli J, Stengel D, Harter P, Kurzeder C, Belau A, Bogenrieder T, Markmann S, Mahner S, Mueller L, Lorenz R, Nugent A, Wilke J, Kuznik A, Doering G, Wischnik A, Sommer H, Meerpohl HG, Schroeder W, Lichtenegger W, Oskay-Oezcelik G. Topotecan Weekly Versus Conventional 5-Day Schedule in Patients With Platinum-Resistant Ovarian Cancer: a randomized multicenter phase II trial of the North-Eastern German Society of Gynecological Oncology Ovarian Cancer Study Group. J Clin Oncol. 2011 Jan 10;29(2):242-8. Epub 2010 Nov 29. link to original article contains verified protocol PubMed
Regimen, Rothenberg, et al. 2004
- Vinorelbine (Navelbine) 30 mg/m2 IV once per day on days 1 & 8
21-day cycles
References
- Rothenberg ML, Liu PY, Wilczynski S, Nahhas WA, Winakur GL, Jiang CS, Moinpour CM, Lyons B, Weiss GR, Essell JH, Smith HO, Markman M, Alberts DS. Phase II trial of vinorelbine for relapsed ovarian cancer: a Southwest Oncology Group study. Gynecol Oncol. 2004 Dec;95(3):506-12. link to original article contains protocol PubMed