Medical Health Encyclopedia

Chemotherapy Agents Studied for Relapsed or Refractory Cancer. Unfortunately, some ovarian tumors are resistant to platinum drug. Even in patients who respond, the disease eventually becomes resistant to the first-line drugs and the cancer returns. Various approaches for increasing responsiveness to these agents are being investigated. Investigators are studying two approaches for preventing relapse after remission:

• Developing more effective drug combination regimens to increase initial response rates and duration of the response.
• Develop maintenance drugs to prevent or delay relapse.

Text Continues Below

---

Once cancer recurs or continues to progress, a number of second-line chemotherapies are available or under investigation. The following lists some of agents that are being used, usually as single drugs, for relapsed or refractory cancers:

• Paclitaxel or carboplatin alone or in combination. A landmark study published in the July 2003 Journal of Clinical Oncology, found that extended use of paclitaxel significantly delayed disease progression in women with advanced ovarian cancer.
• Pegylated liposomal doxorubicin (Doxil, Myocet, Caelyx in Canada) is a liposome-encapsulated form of doxorubicin that remains in the blood stream longer, tends to spare the bone marrow, and move selectively through the tumor. It is showing promise in clinical trials and also may have fewer toxic effects than standard doxorubicin and other agents used for ovarian cancer. Studies show that Doxil is very well tolerated with a total response rate of about 20-30% in patients with recurrent cancer. This compares favorably with other agents such as Topotecan, Carboplatin, and Taxol.
• Topoisomerase I inhibitors, including topotecan (Hycamtin) and irinotecan (Campto).
• Nucleoside analogs, including gemcitabine (Gemzar).
• Topoisomerase II alpha inhibitors, including etoposide (Vepesid).
• Alkaloids, including vinorelbine (Navelbine)
• Hormonal agents: tamoxifen (Nolvadex) or anastrozole (Arimidex).
• Other agents. Valspodar and capecitabine (Xeloda) are oral agents that may help improve response to other drugs, although data are preliminary.

Administration of Chemotherapy