Dear OncoLink "Ask The Experts,"
My sister-in-law has stage 3c ovarian cancer. She has had surgical debulking and is now undergoing 6 carbo/taxol cycles. Do you have an opinion on consolidation therapy? I know it's controversial but could you address it for the rest of us?
Christina S. Chu, MD, Assistant Professor of the Division of Gynecologic Oncology at the University of Pennsylvania Health System, responds:
You are right that consolidation therapy (or additional treatment after a complete remission is achieved) is very controversial for patients with ovarian cancer. Currently, there is no standard accepted therapy. Many different regimens have been investigated. Some examples include intraperitoneal radioactive phosphorous (P32), whole abdominal radiotherapy, intraperitoneal cisplatin and etoposide, and intraperitoneal mitoxantrone. A recent large, phase III clinical trial reported preliminary results following treatment with either 3 or 12 months of Taxol chemotherapy. On average, patients in the 12 month treatment group appeared to have a longer interval before disease recurred by 7 months, compared to the patients treated in the 3 month group. These results are only preliminary, and are very controversial as well, since the study investigators stopped the trial before data regarding overall survival could be collected. Also, the additional side effects of 12 months of treatment are concerning (several patients in the 12 month treatment group chose to discontinue therapy because of side effects). Because of the controversy, patients at our institution are not routinely counseled to undergo consolidation therapy outside of the confines of a clinical trial. We will soon begin a clinical trial to study an anti-tumor vaccination as a possible consolidation therapy for ovarian cancer.