Ovarian Cancer: Adjuvant Therapy

For women with ovarian cancer who undergo surgery, chemotherapy is often required after surgery. This type of treatment is known as adjuvant therapy. The goal of adjuvant therapy is to eradicate any microscopic areas of cancer that remain in the body after chemotherapy. Some women with very early ovarian cancer may not require chemotherapy after surgery.

Intravenous Chemotherapy

Chemotherapy administered through the vein (intravenous) is the most common form of chemotherapy treatment for ovarian cancer. The two most commonly utilized drugs for this type of treatment in ovarian cancer are carboplatin and paclitaxel. The drugs are administered in one of two ways, either as an infusion every 3 weeks or as a weekly infusion.

Intraperitoneal Chemotherapy

Sometimes chemotherapy for ovarian cancer can be administered directly into the abdominal cavity (intraperitoneal chemotherapy). The rationale for delivery of chemotherapy in this form is that most ovarian cancer cells are found in the abdominal cavity. Intraperitoneal chemotherapy allows for the delivery of a higher concentration of chemotherapy directly into the tumor cells.

Delivery of intraperitoneal chemotherapy requires a special device known as an intraperitoneal port for delivery of the chemotherapy. The intraperitoneal port can be placed at the time of initial surgery or in a subsequent surgery.

Studies have suggested that intraperitoneal chemotherapy can increase the chance of long-term survival in some women compared to some other forms of ovarian cancer. Research studies have also shown that intraperitoneal chemotherapy is associated with more side effects and may not be well tolerated by all women.

Consolidation Therapy

Most women with ovarian cancer receive several cycles (6-9) of chemotherapy and then enter a period of surveillance. For some women consolidation therapy may be recommended. Consolidation or maintenance chemotherapy is a strategy where by women receive additional chemotherapy after adjuvant treatment.

The potential benefit of consolidation chemotherapy is that it may prevent the recurrence of ovarian cancer in the future. Scientific studies have reported mixed results on this concept and, to date, consolidation chemotherapy has not been convincingly shown to improve survival for women with ovarian cancer.

Consolidation therapy may entail treatment with a typically chemotherapeutic drug such as paclitaxel or alternatively a molecularly targeted agent such as bevacizumab. Consolidation therapy is often administered for 6-12 months after initial treatment.