chemo opinion

[unmai]

Diagnosed in 2003 (age 48) with Ovca stage 3c.

Taxol/carbo 6 rounds immediately after optimal debulking
CA125 normal after first round

[unmai]

Thanks Dr. Goodman.  We appreciate your time.  

We would like to find more info about Avastin/cytoxan.  Is it approved for ovarian ca - will insurance pay for it?

Thanks again!

[Annekathryn Goodman, M.D.]

Hi There,
What a rough road you guys have been on! It sounds like she has developed a very tough recurrence. Ovarian cancer is initially sensitive to many different types of chemotherapy. However when the recurrences occur with such a short interval, the cancer cells that are growing back are usually the ones that were not killed by the previous chemotherapy. Therefore those recurrent cancer cells can be resistant to other chemotherapy agents.

Chemosensitivity assays have been around for at least 20 years. There is controversy about whether the results of how cancer cells in a test tube get killed by chemotherapy correlates to how well that chemotherapy works in the human body. So despite chemosensitivity assays suggesting that certain drugs are not helpful, sometimes we try them anyway.

For instance, it sounds like this cancer is sensitive to carboplatin. There is a protocol for people who have a carboplatin allergy where the drug can be given very slowly and under careful observation.

As far as doxil goes, it is a very slowly working drug. it usually takes 3 to 4 cycles before an effect is seen.

Another option is to consider avastin (bevicizumab) with another agent such as cytoxan. Avastin seems very helpful in reducing ascites.

Finally , you should ask your oncologist about clincial research trials that maybe available.