When a woman is first diagnosed with ovarian cancer, the treatment program is determined based on the stage of the cancer, using guidelines published by the National Comprehensive Cancer Network (NCCN). NCCN is an organization of medical professionals that develops therapy recommendations based on results of scientific studies.
Initial Diagnosis of Ovarian Cancer: First-line Treatment
The current NCCN guidelines recommend that initial treatment for ovarian cancer include surgery combined with chemotherapy drugs, usually a platinum-taxane combination, that work by disrupting the cell division process and killing fast-growing cells. Because cancer cells are dividing more rapidly than normal cells, the cancer cells are preferentially killed by the drugs; however, normal cells are killed as well.
Recurrence: Therapy Options When Ovarian Cancer Returns
Most patients with advanced stage disease have tumors that respond to initial therapy, but if the tumor does not respond, the cancer is considered refractory. Unfortunately, 75-80% of the women who initially respond will have a recurrence of their disease. Chemotherapy drugs become less effective over time, as cancer cells change rapidly and develop resistance. These newly resistant cancer cells may continue to divide, ultimately forming new tumors. This can happen within six months of ending treatment (i.e., platinum-resistant) or more than six months and even years later (i.e. platinum-sensitive).
When a woman has recurrent ovarian cancer, her physician has many chemotherapy drugs and clinical trial drugs from which to choose. Unlike at initial diagnosis, where the platinum-taxane combination is effective in most women, the choice at recurrence is more complex and is affected by additional factors, such as how much time has passed since the initial treatment. Learn more about the effectiveness of drugs used to treat platinum-sensitive or platinum-resistant recurrence.
Without a standard-of-care to guide which drugs are most likely to work, various treatment regimens may be tried in a “trial-and-error” approach.
Maintenance: Therapy to Keep Cancer From Coming Back
After therapy (first-line or recurrence) some patients may receive maintenance treatment. Maintenance treatment is given to prolong the duration of remission and lower the risk of the cancer coming back after it has been treated. Maintenance therapy can also be used to keep advanced cancer from growing more. Patients will often take maintenance therapy for months or even years. Learn more about the effectiveness of maintenance therapies.
Clearity Foundation’s Tumor Blueprint
The Clearity Foundation is dedicated to transforming treatment for recurrent ovarian cancer by enabling more informed treatment choices based on each woman’s unique tumor molecular profile.
Using Molecular Profiling to Guide Cancer Therapy Decisions
Doctors are routinely using molecular testing to make treatment choices for patients with conditions like breast, colon and lung cancer. In ovarian cancer, molecular testing is used to determine if a patient is BRCA positive (i.e., BRCA1 or BRCA2 mutations were found by a blood test or in their tumor) since if she is positive, she may be eligible for drugs called PARP inhibitors (e.g., olaparib, rucaparib, or niraparib). But with the exception of BRCA status, personalized treatment approaches based on results from molecular tests are not commonly used for ovarian cancer patients. The Clearity Foundation wants to change that. Our Tumor Blueprint provides you with molecular information specific to your tumor which can help you and your physician choose a course of drug treatment that matches your tumor and may therefore be more effective than other options. Learn more about Clearity’s Tumor Blueprint.