Systemic Treatment of Ovarian Cancer Recurrence
A living guideline by ASCO.
These guideline summaries are shared for educational purposes only and are not intended to direct patient care. For detail on the specific recommendations and information about the evidence considered by the guideline developer, we encourage you to go to the original guideline statement cited below.
Treatment
Clinicians may offer a combination of pegylated liposomal doxorubicin (PLD) + carboplatin.
Clinicians may offer paclitaxel + carboplatin.
Clinicians may offer a combination of gemcitabine and carboplatin.
Clinicians may offer bevacizumab in combination with a platinum-based doublet, followed by bevacizumab maintenance.
Clinicians should not offer trabectedin in addition to PLD.
Clinicians may offer maintenance bevacizumab to patients PSOC who have responded to platinum-based therapy in combination with bevacizumab.
There is insufficient evidence or Expert Panel agreement to provide a recommendation for or against secondary cytoreduction for patients with recurrent PSOC to guide clinical practice at this time.
There is insufficient evidence or Expert Panel agreement to provide a recommendation for or against hyperthermic intraperitoneal chemotherapy (HIPEC) for patients with recurrent PSOC to guide clinical practice at this time.
Clinicians should offer mirvetuximab soravtansine for patients with high-grade PROC and validated results for positive folate receptor alpha (FRα) expression by immunohistochemistry (75% of cells with ≥2+ [i.e., 2+ or 3+] staining intensity).
Clinicians should offer PLD monotherapy.
Clinicians should offer bevacizumab in combination with chemotherapy.
Clinicians should offer paclitaxel with either a once weekly or once every three weeks schedule for administering paclitaxel.
Clinicians may offer relacorilant and nab-paclitaxel.
Clinicians may offer gemcitabine monotherapy as an option.
For patients with PROC there is insufficient evidence to make a recommendation regarding the role of cytoreductive surgery in their treatment.
Monitoring and/or Surveillance
Clinicians may offer clinical follow-up (monitoring) to patients with recurrent PSOC after completion of anti-cancer treatment.
Clinicians may introduce ongoing specialty survivorship care for patients with PROC who have received first-line treatment.