Concerns re: Treatment Options

[C.Ann]

dx 7/2001, stage 3c OvCa, surgery plus 9 rounds of taxol/carboplatin

1st recurrence 8/2005 treated with 2 rounds of taxol/carbo but developed allergy to carbo, 4 remaining treatments with taxol only

2nd recurrence 7/2006, 5 rounds of doxil not tolerated well, dosage 40, CA tracked in this way...30, 21, 15, 24, 51, 98 (recent-this week) clean CT Skan after 4th treatment, PT skan yesterday await results

Decision is to stop Doxil and begin Taxotere. My concern is that we are eliminating a lot of options by trying another taxane drug that may not work.  I see other options as I research such as; antiogiogenisis drugs in combo with taxotere or cytoxan, vacine treatments, desensitization to the carbo to enable me to tolerate it.

I would appreciate your opinion re: next step and how much time I have to make that decision. I am not sure how long I should wait while doing research. Thank you so much.

[Annekathryn Goodman, M.D.]

Hi There,
Thank you for your excellent question. Please see my last post to Tybear (Becky) where I listed different drugs.

I agree with your thoughts. I would ask your doctor about densitization to carboplatin and find out what is the program available for that at your hospital. People do need to be admitted  for a 24 hour infusion. At MGH, we have an allergist on staff who specializes in the densitization protocol. So it is a bit work intensive.

While taxotere is a perfectly good option, I agree that other drugs should be considered as well. There really is no wrong answer. We have looked at the addition of avastin to taxol or cytoxan. This is not an FDA approved use of this expensive drug so it is usually done on a protocol.  From our limited experience so far, avastin is very helpful for ascites and liver metastases. It has not been routinely considered especially in the abscence of measureable disease (that is nothing seen on a Ct scan.)

It sounds like you have time to carefully think this through - if you have a normal scan and have no symptoms. There are many oncologists who would suggest just tamoxifen or arimedex for the treatment of an elevated CA 125 without other findings.
best wishes to you