Recurrent ovarian cancer treatment

Hello,
My dx was stage 3c in 6/2008.  I was a participant in the GOG trial using standard chemo plus either Avastin or a placebo however my cancer recurred almost immediately upon completion of the 6 treatments of Carbo/Taxol.  My oncologist is now recommending Topotecan for my next round, 3 weeks on 1 week off.  My question is why is one drug suggested over another ie. why not Doxil or Gemzar?  Also, are there any statistics showing the rate of success of Topo for second line therapy?
Thanks,
Sharon
  

[Kamal S Saini, MD, MRCP (UK), DM]

Hi,
I assume that you got the chemo for the commoner epithelial type of ovarian cancer. What surgery was performed? What were the Ca 125 levels before and after chemotherapy? Did the cancer disappear completely before re-appearing?
Your cancer is platinum resistant, as it came back shortly after completing platinum based treatment.
According to the NCCN (National Comprehensive Cancer Network) 2009 guidelines, acceptable chemotherapy drugs in relapsed (platinum resistant) ovarian cancer include liopsomal doxorubicin, docetaxel, gemcitabine, etoposide, paclitaxel (weekly), pemetrexed, and topotecan.
There is no overwhelming data to support the selection of one drug over the others, and doctor and patient preference plays a large part in deciding which agent to choose. In phase III clinical trials, topotecan proved to be equivalent in efficacy to both paclitaxel and liposomal doxorubicin as second-line therapy in patients with relapsed ovarian cancer.
Alternatively, you may decide to enrole in another clinical trial.
All the best, and God Bless!

[bohan54]

I had a total hysterectomy with optimal debulking.  Highest CA 125 was 2900, it went to 28 after 6 rounds of Carbo/Taxol.  There was a 7mm spot leftover which when grew to 9mm in 2 months.  Biopsy done on 3/6/09 confirmed  malignancy.  
Thank you for your prompt reply to my question.   Will give the Topotecan a try and hope for stability.
Sharon

[Kamal S Saini, MD, MRCP (UK), DM]

Hi Sharon, I wish you good luck!