Secondary Chemo Treatment

My wife has had 6 sessions of carboplatin and taxol and her CA125 is at 113.  We will have the Cat Scan in 3 weeks.  The doctors do not like her CA125 level and will meet with us to discuss alternate and additional chemo treatment.  Can you give some sense of what other chemo treatment might be?

[Annekathryn Goodman, M.D.]

Hi There
all good suggestions.

First it will be important to see what the CT scan shows.
If there is no major abnormalities on CT scan, she could consider taking a break to let her bone marrow recover.

Other options as discussed include:
weekly taxol,
topotecan
doxil
doxil plus carboplatin
there is a new drug, yondelis

finally if the CT scan does not show significant disease, she could consider something like tamixifen or arimidex. both are anti-estrogen hormones and have less side effects than chemo.

I agree with PerB's comment to check the pathology report. Perhaps some element about the pathology can help guide therapy
best wishes

[MinnieWM]

All of my friends who didn't respond completely to the carbo/taxol regimen, then went on Doxil.  The most recent one is in remission now.  I'm sure there are other regimens for those who are platinum refractory or resistant.

[PerB]

My wife also had 6 sessions of carboplatin and Taxol and her CA125 stayed around 100 during the entire treatment. The CT then showed two metastasis in the liver, i.e. the cancer was platinum refractory. The doctors then chose weekly Taxol (although doxil/caelyx was contemplated). That went on for 3 months, then a new CT showed 13(!) metastasis in the liver (we had suspected progress due to ascites+DVT but still...). Then the doctors chose a combination of Irinotecan and 5FU/folinic acid called "the modified de Gramont regimen", which is otherwise a treatment for GI cancer. This was chosen because of a large element of mucinous cancer - which apparently resembles GI cancer (and, as I learned later on, is more or less known to be Pt refractory). She is still on this biweekly, and although the treatment is rather tough with mouth sores, chemo fog etc., a new CT indicated no apparent tumor progress, and the ascites is gone. So it seems to work this time.
So my messages would be: check the pathology report - if there is a large element of mucinous cancer, you could tell the doctors my story.