How long should first-line chemotherapy continue?

Documentation for the optimal duration of first-line chemotherapy in advanc ed ovarian cancer is limited. Three randomised trials have compared 5-6 cyc les with 8, 10 and 12 cycles respectively. None of the studies showed benef it of chemotherapy beyond 6 cycles. At the moment the standard number of cy cles therefore must be 6 cycles. However, these data are based on platinum poly-chemotherapy regimens without taxanes. It may be that the optimal numb er of cycles is different when using taxanes regimens. It is not possible t o tell from the literature if there is a relationship between the number of cycles and response or between the cumulative dose and response. At the moment no trial has shown any benefit of high-dose intensity chemoth erapy administered over a short time compared with standard dose chemothera py administered over a longer period.