Dr. Dalton on the Standard of Care in Ovarian Cancer

Heather Dalton, MD, gynecologic oncologist, Arizona Oncology, discusses the standard of care for patients with ovarian cancer.

Physicians have never quite determined what the standard of care should be for patients with ovarian cancer. Every clinical trial seems to muddy the waters even more, says Dalton. The initial dose-dense regimen showed an improvement in overall survival that rivaled that of intraperitoneal (IP) chemotherapy. Physicians began to embrace the use of dose-dense regimens, but the results of the GOG 252 trial complicated that significantly.

GOG 252 showed no difference in survival between the 2 regimens. This has been attributed to the differences in cisplatin that were given as compared with the ones given in GOG 172 versus the addition of bevacizumab (Avastin). As it stands now, a dose-dense regimen is a good option for a patient with a suboptimally debulked tumor who is not as robust as a younger patient. Fractionated treatments may also be worthy of consideration. IP chemotherapy is a good option for a patient with an optimally debulked tumor and good performance status.