Dr. Salani on Choosing Among IV, IP, and Dose-Dense Chemo Regimens in Ovarian Cancer

Ritu Salani, MD, gynecologic oncologist, associate professor in Department of Obstetrics and Gynecology, and director of the Gynecologic Oncology Fellowship Program at The Ohio State University Wexner Medical Center, The Ohio State Comprehensive Cancer Center—The James, provides insight into how to approach selection of chemotherapy in ovarian cancer.

Choosing between chemotherapy options in ovarian cancer is always challenging, says Salani. The available data are interesting because they indicate a strong drop-off in the role of intraperitoneal (IP) chemotherapy. Part of that is because of the toxicities associated with the regimen, as well as the challenges of placing an IP port and catheter in a patient, explains Salani. Other data show that outcomes with IP chemotherapy may be comparable when bevacizumab (Avastin) is added to it or use other dosing schedules.

The route selection for each patient makes a difference, adds Salani. Studies have shown that some patients tolerate dose-dense chemotherapy better than the conventional every-3-week regimen, which may be because of the toxicity profiles. Schedule convenience for patients is also a factor that needs to be taken into consideration, says Salani. Patients may be traveling from long distances and visiting every 3 weeks as compared with every week may help alleviate some of that burden, concludes Salani.