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Ovarian cancer drug treatments

Alkylating agent

Altretamine or Hexalen 50mg caps 260mg/m² daily in four divided doses for either 14 or 21 consecutive days in a 28 day cycle

Carboplatin 10mg/mL soln for IV infusion

300mg/m² on Day 1 every 4 weeks for 6 cycles, recurrent ovarian cancer: 360mg/m² on Day 1 every 4 weeks

Cisplatin 1mg/mL soln for IV infusion after dilution

100mg/m² once every 4 weeks

Cyclophosphamide 25mg, 50mg tabs 1–5mg/kg/day

Cyclophosphamide 500mg, 1g, 2g pwd for inj after reconstitution

40–50mg/kg in divided doses over 2–5 days or 10–15mg/kg every 7–10 days or 3–5mg/kg twice weekly

Melphalan Alkeran 2mg scored tabs

-0.2mg/kg/day for 5 days; repeat every 4–5 weeks

Thiotepa 15mg pwd for IV, intravesical, or intracavitary administration after reconstitution

0.3–0.4mg/kg IV once every 1–4 weeks

Doxorubicin Adriamycin 10mg, 20mg, 50mg pwd for IV inj after reconstitution

Monotherapy: 60–75mg/m² every 21 days

Combination therapy: 40–60mg/m² every 21 to 28 days

Adriamycin Solution

Doxorubicin (liposomal) Doxil 2mg/mL dispersion for IV infusion after dilution

50mg/m² once every 4 weeks

Antimetabolite

Gemcitabine Gemzar 200mg, 1g pwd for IV infusion after reconstitution

1000mg/m² on Days 1 and 8 of each 21 day cycle

Hydroxyurea Hydrea

500mg caps Intermittant therapy: 80mg/kg as single dose every 3rd day

Continuous therapy: 20–30mg/kg/day as single dose

Antimicrotubule agents

Paclitaxel Taxol 6mg/mL soln for IV administration after dilution

175mg/m² over 3 hours or 135mg/m2 over 24 hours; repeat every 3 weeks

Topoisomerase inhibitor

Topotecan Hycamptin 4mg pwd for IV infusion after reconstitution and dilution

1.5mg/m² daily for 5 consecutive days starting on Day 1 of a 21-day cycle

Maintenance therapy and ovarian cancer is effective in first line and recurrent settings.
Maintenance therapy includes Bevacizumab , and PARP inhibitors.
 Bevacizumab Needs to be started concurrently with chemotherapy and then continued to maintenance. 
 
PatientS who benefit from Bevacizumab In the setting of first line residual disease, if the disease has been suboptimally debunked, or if they have stage IV disease.
Patients with BRCA mutations are very sensitive to PARP inhibition and are the ones most likely to benefit from maintenance from PARP inhibitors.
Carboplatin-pegylated liposomal doxorubicin and Bevacizumab had a better progression free survival than carboplatin, gemcitabine and Bevacizumab and may be a new standard treatment option for platinum eligible tecurrent ovarian cancer patients.

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