4th line options for 3d recurrence

1st line 6 cycles iv taxol + carbo & 3 cycles IP cisplatin consolidation (1 Year Remission)
2d line 6 cycles iv carboplatin + Doxil ( No surgery) and PET/CT at end of treatment showed No Evidence of Disease ( 1 Year Remission)
3d line Gemzar + Avastin + Oxaliplatin (no surgery) and PET/CT at end of treatment showed No Evidence of Active Disease 7 month remission

Latest CA 125 up from 34 to 145 in 3 month period but completely asymptomatic.

She will go in for a PET/CT this week.  What our our chemo options this time.  She has not shown documented resistance to any chemo received so far.

(1) Can she go back to Carboplatin?  Since the last time she received Carboplatin was 20 months back for her 2d line.
(2) What chemo option would you think of in this setting.  All other blood work came in normal.

[Annekathryn Goodman, M.D.]

Hi There
nice to hear from you and thank you for your update
all those options are very reasonable
weekly taxol is the most frequently used

but  trabectin (Yondelis; ET743).   is something she has never seen before so that might be  an interesting option
please let us know how she is doing
take care

[OVCIndia]

Mom met the oncologist to followup on PET results.  The scan shows peritonial spread across abdomen and around spleen, and liver.  The largerst on the liver peritonium is around 2cm and is infiltrating into the liver.  Some upper abdomen lymph nodes are involved too.

The oncologist suggesed 3 options

1) Weekly Taxol
2) Weekly Abraxane
3) Trabectedin

[OVCIndia]

Dr Goodman,  Mom completed 6 weekly taxol infusions and had her CA125 today which came in at 28 down from 145 before start of therapy. Her Onc also asked for a pelvic and abdomen ultrasound since she has had too many PET/CT scans in the last 5 years and CA 125 is a very good marker for her.  

Her Ultrasound came back normal and no lesions could be seen on the liver, kidney, Pancreas, Splen, Gallblader (gallbladder) and liver.

She still has 10 more weekly taxol treatments to complete.

From what i have read response to weekly taxol is usually short and the tumor grows back once taxol is stopped.

How long should one continue on weekly taxol in this setting?

[Annekathryn Goodman, M.D.]

Hi There,
that is great that your mother had such a good response to the taxol.
there are some people who might just stay on the weekly taxol indefinitely
or change to 1-2 weeks on and 2-3 weeks off as maintenance.

neuropathy can be the limiting factor
but I have successfully kept a few people on weekly taxol for 1-2 years
best wishes