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NCCN Guidelines for Patients



Ovarian Cancer, Version 1.2017


Treatment guide

Stages II, III, and IV ovarian cancer

Guide 9

shows the options that are recommended

after primary chemotherapy for stage II, III, or IV

ovarian cancer. The next options depend on how

well primary chemotherapy worked. An outcome

or improvement related to treatment is called a

treatment response.

A complete response is when there are no signs of

cancer on the imaging tests, physical exam, or CA-

125 blood tests after treatment. A partial response

is when tests show a decrease in the amount of

cancer, tumor size, or CA-125 levels. It means

that the cancer improved, but it is not completely

gone. Persistent disease is cancer that stayed the

same—didn’t get better or worse—during treatment.

Progressive disease is cancer that continued to grow

(progress) during or after treatment.

Treatment options

If tests showed a complete response, then you have

four main options to choose from. The first option is

to receive treatment within a clinical trial. A clinical

trial is a type of research that studies how safe and

helpful a treatment is. The second option is to begin

observation with follow-up tests. Observation is a

period of testing to watch for cancer growth after

treatment. Another option is to begin maintenance

treatment with paclitaxel or pazopanib. Maintenance

treatment is given to continue (maintain) good

treatment results.

For maintenance treatment, paclitaxel is given in

a vein on Day 1 of a 28-day cycle for a total of 12

cycles. But, not all doctors recommend paclitaxel as

maintenance treatment. It is important to discuss the

benefits and risks with your doctor.

Guide 9. Treatment after primary chemotherapy

Chemotherapy results Treatment options

Complete response

Tests show that the cancer is

completely gone; all signs and

symptoms have disappeared


• Clinical trial


• Observation with follow-up tests


• Maintenance treatment with pazopanib


• Maintenance treatment with paclitaxel

Partial response

The cancer has improved but it’s

not completely gone; some signs

and symptoms remain


• Clinical trial


• Start recurrence treatment


• Best supportive care

Persistent or progressive disease

The cancer stayed the same or it

continued to grow during treatment


• Clinical trial


• Best supportive care


• Start recurrence treatment