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Chemoresistance in ovarian and primary peritoneal cancer

Chemoresistance in ovarian and primary peritoneal cancer

Question

Dear OncoLink "Ask The Experts,"

I have been fighting primary peritoneal cancer for 4 1/2 years with suboptimal debulking and continued chemotherapy. I had one 9 month remission in the beginning. At this point all the chemotherapies we have tried have not been working. I was told I am chemoresistant at this point. I am about to try etoposide. What does all this mean?

 

Answer

Christina S. Chu, MD, Assistant Professor of the Division of Gynecologic Oncology at the University of Pennsylvania Health System, responds:

Unfortunately, many patients like you with ovarian and primary peritoneal cancer may experience disease recurrences which may be adequately controlled by chemotherapy for a time, but often the chemotherapy ceases to work after a certain period. This is what is meant by "chemoresistance"--the tumor becomes resistant to the effects of the chemotherapy and begins to grow again.

In the setting of recurrent ovarian and primary peritoneal cancer, many chemotherapies are available, but after becoming "resistant" to many treatments, only about 15-20% of patients respond to any of the available standard therapies. Etoposide may be a fine choice for your situation. I would also encourage you to seek out any Phase I clinical trials of new drugs that may be available in your area.