Chemotherapy Options for Women With Ovarian Cancer
- Chemotherapy is usually paired with surgery to treat ovarian cancer
- A combination of drugs called carboplatin and paclitaxel is the most commonly-administered chemo
- New drug options include Avastin and PARP inhibitors
When it comes to chemotherapy for ovarian cancer patients, there isn’t really a one-size-fits-all approach. There are several different types of drugs and different protocols that doctors can select among, choosing combinations, dosages, and treatments they think will best work for their patients. That said, there are some drugs that are considered the gold standard for treatment. “The standard chemotherapy for ovarian cancer would be with platinum and taxane, two drugs given through the veins,” says Dr. Marta Crispens, a gynecologic oncologist at Vanderbilt Health in Nashville.
Most commonly, the platinum-based therapy is carboplatin and the taxane is paclitaxel. These two drugs are generally given together at three week intervals, meaning they’re administered to the patient every three weeks for a set amount of time.
The timing of these drug therapies depends on the larger treatment plan. If a patient is receiving chemotherapy before they undergo surgery, they will usually receive three chemotherapy treatments prior to the surgery and three treatments again afterwards. But if the patients undergo surgery as a first treatment, they will usually receive six chemotherapy treatments after recuperating from the operation.
The main side effects of carboplatin and paclitaxel are that they can lower blood counts, which can make patients susceptible to bleeding and infections. The blood counts can sometimes be low enough to require a transfusion. The drugs also can cause nausea, vomiting, and fatigue, though there are now treatments that can help minimize these problems. And, of course, these drugs cause hair loss. While there is no way to prevent hair loss, some patients use cooling caps to slow the thinning.
While carboplatin and paclitaxel are probably the most commonly used drugs to treat ovarian cancer, there are other options. The drug Avastin, for instance, is another drug delivered intravenously that can be given along with other chemotherapy medications. Avastin works by affecting the growth of blood vessels, starving tumors of the blood they need as nourishment. Avastin may also be used as a maintenance therapy for a year or so after surgery.
And now there are also PARP inhibitor drugs available for ovarian cancer patients. These drugs work by preventing cancer cells from repairing their damaged DNA. Once given only to women who carried the BRCA gene mutation, PARP inhibitors are now available to any woman with ovarian cancer, no matter what her stage of treatment. PARP inhibitors come in pill form, so women can take these drugs at home without having to travel to a hospital or medical facility–especially important during the COVID-19 pandemic.
Most recently, the American Society of Clinical Oncology (ASCO) released new guidelines recommending PARP inhibitors be offered to women, with or without genetic mutations, who are newly diagnosed with stage III or IV ovarian cancer and have improved with chemotherapy.
Chemotherapy During COVID-19
Researchers and oncologists are trying to understand how cancer patients are affected by the new coronavirus and whether they’re at increased risk of complications. Until then, cancer patients are advised to follow all CDC guidelines for protecting themselves from infection: social distancing, wearing masks, avoiding touching the face, staying home and avoiding others as much as possible. “Our knowledge of the disease is rapidly growing and changing every day, and decisions regarding therapy have to be made on an individual basis between a provider and a patient,” says Dr. Crispens.
During the pandemic there has been a major shift to telemedicine, as many hospitals and medical centers have opted for online meetings rather than in-person visits to minimize the risk of exposure. These virtual visits allow for a safer means of patient-doctor communication, where patients can still receive reliable medical advice about any concerns they have. Obviously, though, chemotherapy and surgery cannot be delivered through a computer screen. As the pandemic wanes, in-person medical visits will become more common again. In the meantime, oncologists are studying the virus and taking steps to make sure that chemotherapy and surgery are done safely.
Learn more about SurvivorNet's rigorous medical review process.
Marta A. Crispens, MD, is director, division of gynecologic oncology at Vanderbilt University Medical Center. Read More
Chemotherapy Options for Women With Ovarian Cancer
- Chemotherapy is usually paired with surgery to treat ovarian cancer
- A combination of drugs called carboplatin and paclitaxel is the most commonly-administered chemo
- New drug options include Avastin and PARP inhibitors
When it comes to chemotherapy for ovarian cancer patients, there isn’t really a one-size-fits-all approach. There are several different types of drugs and different protocols that doctors can select among, choosing combinations, dosages, and treatments they think will best work for their patients. That said, there are some drugs that are considered the gold standard for treatment. “The standard chemotherapy for ovarian cancer would be with platinum and taxane, two drugs given through the veins,” says
Dr. Marta Crispens, a gynecologic oncologist at Vanderbilt Health in Nashville.
Most commonly, the platinum-based therapy is carboplatin and the taxane is paclitaxel. These two drugs are generally given together at three week intervals, meaning they’re administered to the patient every three weeks for a set amount of time.
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The timing of these drug therapies depends on the larger treatment plan. If a patient is receiving chemotherapy before they undergo surgery, they will usually receive three chemotherapy treatments prior to the surgery and three treatments again afterwards. But if the patients undergo surgery as a first treatment, they will usually receive six chemotherapy treatments after recuperating from the operation.
The main side effects of carboplatin and paclitaxel are that they can lower blood counts, which can make patients susceptible to bleeding and infections. The blood counts can sometimes be low enough to require a transfusion. The drugs also can cause nausea, vomiting, and fatigue, though there are now treatments that can help minimize these problems. And, of course, these drugs cause hair loss. While there is no way to prevent hair loss, some patients use cooling caps to slow the thinning.
While carboplatin and paclitaxel are probably the most commonly used drugs to treat ovarian cancer, there are other options. The drug Avastin, for instance, is another drug delivered intravenously that can be given along with other chemotherapy medications. Avastin works by affecting the growth of blood vessels, starving tumors of the blood they need as nourishment. Avastin may also be used as a maintenance therapy for a year or so after surgery.
And now there are also PARP inhibitor drugs available for ovarian cancer patients. These drugs work by preventing cancer cells from repairing their damaged DNA. Once given only to women who carried the BRCA gene mutation, PARP inhibitors are now available to any woman with ovarian cancer, no matter what her stage of treatment. PARP inhibitors come in pill form, so women can take these drugs at home without having to travel to a hospital or medical facility–especially important during the COVID-19 pandemic.
Most recently, the American Society of Clinical Oncology (ASCO) released new guidelines recommending PARP inhibitors be offered to women, with or without genetic mutations, who are newly diagnosed with stage III or IV ovarian cancer and have improved with chemotherapy.
Chemotherapy During COVID-19
Researchers and oncologists are trying to understand how cancer patients are affected by the new coronavirus and whether they’re at increased risk of complications. Until then, cancer patients are advised to follow all CDC guidelines for protecting themselves from infection: social distancing, wearing masks, avoiding touching the face, staying home and avoiding others as much as possible. “Our knowledge of the disease is rapidly growing and changing every day, and decisions regarding therapy have to be made on an individual basis between a provider and a patient,” says Dr. Crispens.
During the pandemic there has been a major shift to telemedicine, as many hospitals and medical centers have opted for online meetings rather than in-person visits to minimize the risk of exposure. These virtual visits allow for a safer means of patient-doctor communication, where patients can still receive reliable medical advice about any concerns they have. Obviously, though, chemotherapy and surgery cannot be delivered through a computer screen. As the pandemic wanes, in-person medical visits will become more common again. In the meantime, oncologists are studying the virus and taking steps to make sure that chemotherapy and surgery are done safely.
Learn more about SurvivorNet's rigorous medical review process.
Marta A. Crispens, MD, is director, division of gynecologic oncology at Vanderbilt University Medical Center. Read More
