Abstract
Management of advanced epithelial ovarian cancer (EOC) is a therapeutic challenge. Initial debulking surgery followed by paclitaxel and platinum based chemotherapy is currently treatment of choice. Despite objective response in 60-80% of patients, five-year survival rates vary between 10% to 30% for advanced disease1. Failures are due to development of primary or secondary resistance. Treatment- free interval (TFI) from last cycle of chemotherapy is important guiding factor for choosing salvage treatment for treatment of relapse. Patients with more than 6 months of TFI are called platinum sensitive and are candidates for repeat platinum based therapy. Patients with TFI of < 6 months are considered platinum refractory. 2 For later patients - options are use of non platinum drugs e.g. gemcitabine, liposomal doxorubicin, topotecan, oral etoposide (VP-16) etc. Response rate to salvage therapy in platinum refractory disease varies from 15 to 28% with progression-free survival (PFS) of 3-4 months. Recently, newer approaches such as targeted therapy are being evaluated. Bevacizumab - an antiangiogenesis agent is one such drug. Though the drug was initially described for metastatic colon cancer,3 various trials are currently evaluating its role in treatment of EOC both in upfront (primary) and recurrent setting.