Find Information About:

Drugs & Supplements

Get information and reviews on prescription drugs, over-the-counter medications, vitamins, and supplements. Search by name or medical condition.

Pill Identifier

Pill Identifier

Having trouble identifying your pills?

Enter the shape, color, or imprint of your prescription or OTC drug. Our pill identification tool will display pictures that you can compare to your pill.

Get Started
My Medicine

My Medicine

Save your medicine, check interactions, sign up for FDA alerts, create family profiles and more.

Get Started

WebMD Health Experts and Community

Talk to health experts and other people like you in WebMD's Communities. It's a safe forum where you can create or participate in support groups and discussions about health topics that interest you.

  • Second Opinion

    Second Opinion

    Read expert perspectives on popular health topics.

  • Community


    Connect with people like you, and get expert guidance on living a healthy life.

Got a health question? Get answers provided by leading organizations, doctors, and experts.

Get Answers

Sign up to receive WebMD's award-winning content delivered to your inbox.

Sign Up

Ovarian Cancer Health Center

Font Size

Ovarian Epithelial Cancer Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Stage III and Stage IV Ovarian Epithelial Cancer Treatment


The PFS surpassed expectations at the 1.5-year follow-up after cessation of treatment. The weekly regimen had a median PFS of 28.0 months (95% CI, 22.3-35.4 months), and the intermittent median PFS was 17.2 months (15.7-21.1; HR, 0.71), favoring the weekly regimen (P = .0015). The 3-year OS also favored the weekly regimen (P = .03). The 2013 updated results revealed unexpected median survival results for the weekly regimen (median OS, 8.3 years vs. 5.1 years; P = .040); the intermittent regimen results are also noteworthy relative to other clinical trials of weekly dosing schedules.

Other than ethnicity, this trial population differed from other studies in the following ways:

  • A lower median age (57 years).
  • 20% stage II.
  • 11% treated in the neoadjuvant setting.
  • 33% with histologies other than high-grade serous or endometrioid.
  • 33% without high-grade histologies.

Treatment Options for Patients With Suboptimally Cytoreduced Stage III and Stage IV Disease

Cytoreductive surgery

The value of interval cytoreductive surgery has been the subject of two large phase III trials. In the first study, performed by the EORTC, patients subjected to debulking after four cycles of cyclophosphamide and cisplatin (with additional cycles given later) had an improved survival rate compared with patients who completed six cycles of this chemotherapy without surgery.[28][Level of evidence: 1iiB] The GOG-0162 trial was designed to answer a very similar question but used the then-standard paclitaxel-plus-cisplatin regimen as the chemotherapy.[29] This trial did not demonstrate any advantage from the use of interval cytoreductive surgery. The divergence of results may be caused by the efficacy of the chemotherapy obscuring any effects of interval cytoreduction, the wider use of maximal surgical effort at the time of diagnosis by U.S. gynecologic oncologists, or unknown factors. Although many patients with stage IV disease also undergo cytoreductive surgery at diagnosis, whether this improves survival has not been established.

Systemic chemotherapy

Table 2. Paclitaxel/Platinum Combinations Versus Comparator Arms in Trials

Trial Treatment Regimens No. of Patients % Early Crossover Progression-free Survival (mo) Overall Survival (mo)
AUC = area under the curve.
a Statistically inferior result (P< .001-< .05).
GOG-132 Paclitaxel (135 mg/m2, 24 h) and cisplatin (75 mg/m2) 201 22% 14.2 26.6
Cisplatin (100 mg/m2) 200 40% 16.4 30.2
Paclitaxel (200 mg/m2, 24 h) 213 23% 11.2a 26
MRC-ICON3[30] Paclitaxel (175 mg/m2, 3 h) and carboplatin AUC 6 478 23% 17.3 36.1
Carboplatin AUC 6 943 25% 16.1 35.4
Paclitaxel (175 mg/m2, 3 h) and carboplatin AUC 6 232 23% 17 40
Cyclophosphamide (500 mg/m2) and doxorubicin (50 mg/m2) and cisplatin (50 mg/m2) 421 20% 17 40
GOG-111[18] Paclitaxel (135 mg/m2, 24 h) and cisplatin (75 mg/m2) 184 None 18 38
Cyclophosphamide (750 mg/m2) and cisplatin (75 mg/m2) 202 None 13a 24a
EORTC-55931[19] Paclitaxel (175 mg/m2, 3 h) and cisplatin (75 mg/m2) 162 None 15.5 35.6
Cyclophosphamide (750 mg/m2) and cisplatin (75 mg/m2) 161 4% 11.5a 25.8a
1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10
1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10
Next Article:

Today on WebMD

Ovarian cancer illustration
What are the symptoms?
doctory with x-ray
Get to know the Symptoms.
cancer cell
HPV is the top cause. Find out more.
Lung cancer xray
See it in pictures, plus read the facts.
Integrative Medicine Cancer Quiz
Lifestyle Tips for Depression Slideshow
Screening Tests for Women
Graphic of ovaries within reproductive system
Ovarian Cancer Marker
Pets Improve Your Health
Vitamin D
Healthy meal with salmon