After therapy is completed, when there is no evidence of disease or sometimes when there is still some disease left, patients may choose observation or maintenance. Observation is exactly what the name implies: patients stop their cancer treatments and their doctor monitors them to determine if the cancer has returned.
Maintenance is designed to prolong remission and lower the risk of cancer recurrence. It can also be used when there is still cancer present to prevent it from growing. Patients may take maintenance therapies for months or even years. PARP inhibitors are the newest drugs to be shown helpful in these situations.
Maintenance Treatments After First-line Chemotherapy
This table lists the drugs most commonly used for maintenance after first-line treatment. These drugs are listed in the National Comprehensive Cancer Network (NCCN) guidelines as standard treatment options.
|*Stage IV disease, debulking surgery was sub-optimal (>1 cm remaining disease), or ascites was present at diagnosis|
|Bevacizumab (Avastin)||Adding Avastin to frontline chemo, and continuing after chemo, helps keep the cancer from coming back, particularly in patients with high-risk disease*|
|Paclitaxel (Taxol)||Taking Taxol when there is no cancer left after first treatment may increase the time before cancer comes back|
|*BRCA-positive patients have a mutation in the BRCA1 or BRCA2 gene detected in their blood (germline mutation) or tumor (somatic mutation)|
|Olaparib (Lynparza)||Increases the time before cancer comes back in women with BRCA-positive* cancer
To see how effective this drug is, click here.
To see side effects associated with this drug, click here.
To see prescribing information, click here.
There are other treatments, including other PARP inhibitors and vaccines, being evaluated in clinical trials for maintenance treatment after first-line therapy. Visit the clinical trials page and scroll down to find them.
Maintenance Treatments After Recurrence
This table lists the drugs most commonly used when cancer returns more than 6 months after the last platinum treatment and then responds again to platinum-based chemotherapy. These drugs are listed in the National Comprehensive Cancer Network (NCCN) guidelines as standard treatment options. Treatment with these drugs generally starts about eight weeks after completing chemo.
|*BRCA-positive patients have a mutation in the BRCA1 or BRCA2 gene detected in their blood (germline mutation) or tumor (somatic mutation).
**HRD stands for homologous recombination deficiency. This is similar to LOH, which stands for loss of heterozygosity. HRD and LOH are changes in tumor DNA that indicate the tumor looks like one that is BRCA-positive, also called “BRCAness”.
|Olaparib (Lynparza)||Increases the time before cancer comes back. Women that are BRCA-positive* or have a positive HRD** assay benefit most.
To see how effective these drugs are, click here.
There are other treatments, including vaccines, being evaluated in clinical trials for maintenance after successful treatment for recurrence. Visit the clinical trials page and scroll down to find them.