What are the NCCN guidelines on chemotherapy for ovarian cancer?

Updated: Aug 10, 2020
  • Author: Andrew E Green, MD; Chief Editor: Yukio Sonoda, MD  more...
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Answer

National Comprehensive Cancer Network (NCCN) guidelines recommend that patients wishing to preserve fertility be referred to a fertility specialist prior to initiation of therapy. [45] For primary chemotherapy, NCCN recommendations are as follows [45] :

  • High-risk stage IA, IB, or IC epithelial ovarian cancer – Three to six cycles of intravenous (IV) taxane/carboplatin adjuvant chemotherapy
  • Stage II-IV disease – Intraperitoneal chemotherapy, in patients with < 1 cm optimally debulked stage II and III disease; or IV taxane/carboplatin for six to eight cycles
  • Stage II-IV disease, in patients who achieve complete remission with primary treatment – Observation alone; participation in a clinical trial; or postremission paclitaxel (category 3) or pazopanib (category 2B)

For a first recurrence, the NCCN prefers combination platinum-based chemotherapy. Agents for platinum-resistant disease include the following:

  • Docetaxel
  • Etoposide
  • Gemcitabine
  • Liposomal doxorubicin +/- bevacizumab
  • Paclitaxel +/- bevacizumab
  • Topotecan +/- bevacizumab

Agents for targeted therapy include bevacizumab, rucaparib, and olaparib. Hormonal therapy agents may include aromatase inhibitors, leuprolide, megestrol, or tamoxifen.

For details on chemotherapy regimens, see Ovarian Cancer Treatment Protocols


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