Chemotherapy and other Medical Oncology Treatments

The gynecologic and medical oncologists of the Ovarian Cancer Center team offer contemporary standard chemotherapy management options as well as alternative treatment strategies (intraperitoneal administration) and access to novel clinical trials and developmental therapeutics.  Our multidisciplinary team is experienced in managing the side effects of treatment and focuses on preserving quality of life to the greatest extent possible during therapy.

The majority of ovarian cancer patients -- 80 – 85 percent -- will eventually need chemotherapy.  There is a small percentage of Stage I patients who do not need chemotherapy.

Drug resistance assays are used to target the most appropriate chemotherapy regimen.  The patient’s cancer cells are grown in petri dishes, and the cells are treated with different chemotherapy drugs.  A resistance assay determines whether the cells have an extreme drug resistance to a particular drug, indicating that it is 99 percent likely that the drug will not be effective for that patient.  Obtaining information on which drugs are not likely to work allows medical oncologists to tailor therapy to the patient, therefore avoiding unnecessary toxicities. 

Intraperitoneal chemotherapy, targeted directly to the abdominal cavity via an implantable catheter, can be used in patients with little scarring, minimal adhesions, and disease confined to abdominal cavity.

Typical courses of chemotherapy usually involve six to eight cycles (three to four weeks each with rest periods in between) of standard drug combinations using a compound from the platinum family, such as carboplatin or cisplatin, and one from the taxane family – paclitaxel.  When ovarian cancer recurs, the same chemotherapy drugs can be given in additional cycles as well as approved secondary drugs, such as topotecan, doxorubicin, gemcitabine, cyclophosphamide, and others.

Johns Hopkins ovarian cancer patients also have access to the latest clinical trials using existing drugs and novel therapies to combat disease.  Experimental drugs currently undergoing testing at Johns Hopkins include bevacizumab and UCN-01.  Access our clinical trials database for more information.  Bevacizumab is targeted drug that restricts the ability of tumors to make new blood vessels. This starves the tumor of necessary nutrients carried by the blood and may stave off tumor growth.  UCN-01 is an investigational treatment that may aid the chemotherapy drug irinotecan in killing ovarian cancer cells.  It also is being studied in lung and gastrointestinal tumors.

Read more on NEJM study that evaluates survival after secondary debulking and chemotherapy after secondary surgery.

Read more on Intraperitoneal Chemotherapy for ovarian cancer.