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62

NCCN Guidelines for Patients

®

:

Ovarian Cancer, Version 1.2017

5

Treatment guide

Follow-up after initial treatment

Guide 12

(on page 61)

shows the options that are

recommended for recurrence treatment. Recurrence

treatment is given after prior chemotherapy

treatment failed to kill all of the cancer or keep it

away. Recurrence treatments include chemotherapy,

hormone therapy, and targeted therapy drugs. (See

Part 4 for more details about each type of drug.)

Which option is best for you depends on a number of

factors, including the type and length of the treatment

response to prior chemotherapy.

Recurrence treatment is used to treat ovarian

cancer that has come back after a partial or

complete response to prior chemotherapy. It is also

used to treat ovarian cancer that did not respond

or continued to grow during prior chemotherapy

treatment. When cancer comes back after a

complete response, the options depend on how long

it has been since chemotherapy ended.

Cancer is called “platinum-resistant” if the

relapse happens less than 6 months after the last

chemotherapy treatment. This means that platinum-

based chemotherapy drugs such as cisplatin and

carboplatin did not work very well against the cancer.

Therefore a different type of drug is recommended

for recurrence treatment.

Cancer is called “platinum-sensitive” if the relapse

happens at least 6 or more months after the last

chemotherapy treatment. This means that platinum-

based chemotherapy drugs worked well against the

cancer. Therefore, you may receive platinum-based

chemotherapy again as recurrence treatment. This

is the preferred option, especially if it is the first

recurrence. But, other types of drugs may also be

considered.

See Guide 12

.

In some cases, chemotherapy is combined with a

targeted therapy like bevacizumab. Bevacizumab

may be given with carboplatin and either gemcitabine

or paclitaxel. If the bevacizumab continues after

the chemotherapy is done, it is called maintenance

therapy. Bevacizumab may continue until the disease

or side effects worsen.

Maintenance therapy is given to continue (maintain)

good results of prior treatment. Another example of

maintenance therapy is a newly approved targeted

agent called niraparib. This drug is considered for

maintenance therapy after recurrence treatment.

Niraparib may be an option for patients with

platinum-sensitive disease that has a partial or

complete response after recurrence treatment.