CURRENT DRUG-TREATMENT GUIDELINES FOR EPITHELIAL OVARIAN-CANCER

The management of ovarian cancer is developing rapidly with the improv ements in specialist multidisciplinary care. Most patients present wit h advanced disease and require careful surgical debulking followed by platinum-based chemotherapy, The recent introduction of paclitaxel app ears to have improved the prognosis of advanced ovarian cancer by an i ncrement that is similar in size to that seen after the introduction o f cisplatin in the 1970s. Further clinical trials are required to defi ne the optimum combination and dose of the platinum and taxane analogu es, and to establish the role of the many new agents currently undergo ing clinical testing. Useful chemotherapy for second-line treatment in platinum-refractory patients is now available, which, combined with m ore aggressive surgical management, is leading to modest improvements in survival. Improvements in supportive care have enabled increasingly intensive chemotherapy to be given safely. Bone marrow support and in hibitors of specific organ toxicities are likely to be incorporated in to treatment protocols over the next decade. The impact of these treat ments on patients' quality of life and the economic consequences of a more active approach to management will require careful evaluation.