ovarian cancer
stage 1
post surgery
chemotherapy
surgery
1A
1B
1C
USO
BSO
Fertility preserving treatment may be an option for some women
with stage 1C disease.
1A OR 1B
1C
3
high grade
2
cancer grade
Endometrioid
Endometrioid
Serious carcinoma
tumor type
Fertility- sparing options surgery
IV platinum based chemo
IV platinum based chemo
IV platinum based
chemo therapy
watch and wait ( no tx)
Treatment option after
surgery
2 or 3
high grade
stage
stage
Endometrioid
Serious carcinoma
IV platinum based chemo
IV platinum based chemo
Carboplatin and doxorubicin
Docetaxel and carboplatin
Paclitaxel and carboplatin (
preferred)
medicine regimen
Once every 3 weeks
Once every 3 weeks
How often
Once every 4 weeks
same
How many cycles
3 to 6 cycles for endometrioid tumors or 6 cycles for high grade serous tumors
stage 2,3,4
Partail /Complete Remission
done after surgery (adjuvant treatment)
primary option
Maintenance therapy with Bevacizumab + Monitor for return of cancer
chemotherapy
primary option
Stable Disease
Disease Progression
Maintenance therapy with Olaparib (only with BRCA1/2 mutations ) + Monitor for return of cancer
surgery
Maintenance therapy with Olaparib ( if previous regimen was based on it ) Only with BRCA1/2 mutations
surgical staging should be done during surgery to check for cancer cell spread
Maintenance therapy with Bevacizumab (if previous regimen was based on it )
Recurrence Therapy
Supportive Care
docetaxal and carboplatin
carboplatin and liposomal doxorubicin
paclitaxal and carboplatin
paclitaxal, carboplatin and bevacizumab
paclitaxal and cisplatin (IP/IV)
once every 3 weeks for 6 cycles
PLUS
TAH anf BSO are done at the same time and remove ovaries, fallopian tube and uterus
Targeted Therapy
Immunotherapy
Chemotherapy
Hormone Therapy
once a week for 18 days
once every 3 weeks for 6 cycles
once every 3 weeks for 6 cycles
Olaparib
Rucaparib
Bevacizumab
once every 4 weeks for 6 cycles
Pembrolizumab (for MSI-H or dMMR solid tumors)
all 3 given once every 3 weeks for 5-6 cycles
Leuprolide acetate
Megestrol acetate
Aromastase Inhibitors
Tamoxifen
paclitaxal and carboplatin given once every 3 weeks for 6 cycles. bevacizumab is added for cycles 2-6 and may be cont by itself for up to 22 cycles.
Exemestane
Letrozole
Anastrozole
Cisplatin/Carboplatin + Gemcitabine
Carboplatin + Paclitaxel (for women older than 70)
medicine regimen
Carboplatin + Paclitaxel + Bevacizumab
Carboplatin +Gemcitabine + Bevacizumab
Carboplatin + liposomal doxorubicin with/without Bevacizumab