Tuesday, September 19, 2017

Day 19 A Month of Teal: Treatments for Recurrence - Chemotherapy/ targeted therapies

Depending on how your disease presents itself on recurrence you may be offered surgery, chemotherapy or a clinical trial. I was offered surgery and chemotherapy or a clinical trial. A majority of women will have chemotherapy but I strongly urge women to consider a clinical trial.

Below is a list of drugs you may be offered:

Chemotherapy Drugs for Recurrence platinum sensitive:
  • Cisplatin or carboplatin + paclitaxel 
  • Carboplatin + gemcitabine
  • Carboplatin + pegylated liposomal doxorubicin
  • Carboplatin + epirubicin
  • Cisplatin + doxorubicin + cyclophosphamide  ( recurrence 12+yrs)

Carboplatin and Taxol are considered the standard for first time platinum sensitive recurrence

Chemotherapy Drugs for Recurrence Platinum Resistant
  • Paclitaxel
  • Topetecan
  • Gemcitabine
  • Pegylated liposomal doxorubicin
  • Pegylated liposomal doxorubicin + trabectedin
  • Etoposide
  • Hexamethylmelamine (Altretamine)
  • Irinotecan
  • Oxaliplatin
  • Vinorelbine
  • Fluorouracil and capecitabine
  • Tamoxifen
  • Pemetrexed
  • Bevacizumab
  • The U.S. Food and Drug Administration has approved the use of bevacizumab ( Avastin)  in combination with pegylated liposomal doxorubicin, paclitaxel, or topotecan.  Two trials OCEANS and AURELIA showed the improvement in PFS ( progression free survival).
  • Olaparib (PARP inhibitor)- maintenance (9/12/17 FDA Approval) / after 3 or more chemotherapy treatments and a BRCA mutation (2014 FDA approval)
  • Rucaparib ( BRCA mutations, 2 or more chemotherapy treatments, 2016)
  • Niraparib(Maintenance therapy BRCA mutation not required)

For additional information about each of these treatments and evidence for their use  please see
https://www.cancer.gov/types/ovarian/hp/ovarian-epithelial-treatment-pdq#link/_789 
https://www.cancer.gov/news-events/cancer-currents-blog/2017/fda-olaparib-ovarian-cancer-maintenance?cid=eb_govdel

or the NCCN guideline page
https://www.nccn.org/patients/guidelines/ovarian/index.html#63/z 

Dee
Every Day is a Blessing ! 

 

 

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