What you should know about chemotherapy drugs

Women with recurrent ovarian cancer have many important treatment-related questions to consider. You may wonder when your treatment should begin, what medications you should take, and how these drugs will affect your quality of life. Or, if you have already received treatment and your cancer has returned, you may wonder how your treatment options have changed.

One of the most important factors is whether your cancer is platinum- sensitive or platinum-resistant. Platinum-sensitive cancers recur after 6 months or more of remission, are responsive to platinum-based therapy, and are often treated using more than one agent. Patients with platinum-sensitive cancers have the most treatment options available to them. Platinum-resistant cancers recur less than 6 months after initial treatment, are not responsive to platinum-based therapy, and are usually treated with a nonplatinum single agent. Women with platinum-resistant cancer are unlikely to benefit from retreatment with the same chemo- therapy drugs, so these patients must be treated with another type of chemotherapy.1

Once your doctor determines which type of recurrent ovarian cancer you have, you can work together to choose the most effective treatment. You can empower yourself by learning more about commonly-used chemotherapy and hormonal drugs. The following list of common drugs used to treat recurrent ovarian cancer details how they are administered and what side effects they may cause.


Altretamine (Hexalen)

http://www.nlm.nih.gov/medlineplus/druginfo/meds/a601200.html

·      Pills taken orally 3 times a day for 14 days every 21 or 28 days.

·      May cause nausea, vomiting, or reduction in white blood cell count


Capecitabine (Xeloda)

http://www.xeloda.com/

·      Pills taken orally twice a day with food for 14 days every 21 days

·      May cause red or peeling skin, mouth sores, nausea or vomiting, or infrequent reduction of white blood cells


Carboplatin (Paraplatin)

http://www.paraplatin.com/

·      IV given over 15 minutes to 1 hour every 3 to 4 weeks

·      May cause moderate reductions in white and red blood cells and platelet counts, nausea and vomiting, loss of appetite, numbness or tingling in extremities, slight risk of allergic reaction, or mild hair loss

·      Dose-limiting toxicities include a decrease in platelet counts


Cisplatin (Platinol)

http://www.nlm.nih.gov/medlineplus/druginfo/meds/a684036.html

·      IV given slowly over 1 to 2 hours every 3 to 4 weeks

·      May cause severe nausea and vomiting for up to 5 days, kidney damage, low magnesium, nerve damage in hands and feet, hearing loss, decreases in white and red blood cells or platelets or anemia, or mild hair loss

·      Dose may be limited by kidney damage, nerve damage, or hearing loss


Cyclophosphamide (Cytoxan)

http://www.nlm.nih.gov/medlineplus/druginfo/meds/a682080.html

·      IV given over 30 minutes by IV or oral tablets

·      May cause moderate to severe decreases in white and red blood cells and platelet counts, bloody urine, bladder inflammation, nausea and vomiting, and complete hair loss

·      Dose-limiting toxicities include bone marrow suppression and possible cardiac issues


Docetaxel (Taxotere)

http://www.taxotere.com/

·      IV given over 1 hour every 3 weeks

·      May cause severe decreases in white and red blood cells and platelet counts, nausea and vomiting, diarrhea, fluid retention, allergic reaction/rash, and complete hair loss

·      Dose-limiting toxicities include nerve damage in hands and feet


Gemcitabine (Gemzar)

http://www.gemzar.com/Pages/index.aspx

·      IV over 15 to 30 minutes weekly for 3 out of 4 weeks

·      May cause decrease in white and red blood cells/platelets, nausea and vomiting, rash and itching, flu-like symptoms, mouth sores, fluid retention, and mild to moderate hair loss


Irinotecan (Camptosar)

https://www.pfizeroncology.com/sites/pop/pages/camptosar.aspx

·      Infusion which takes 24-48 hours (6 times over 42-day treatment cycle) or by Bolus Injection which takes 5-10 minutes (5 times over 42-day treatment cycle)

·      May cause early and late diarrhea or reduction in white blood cells


Liposomal doxorubicin (Doxil)

http://www.doxil.com/

·      IV over 1 to 3 hours once every 3 to 4 weeks

·      May cause red and peeling skin, mouth sores, reduction of white blood cells (common) or red blood cells or platelets, nausea and vomiting, loss of appetite, or mild hair loss

·      Dose-limiting toxicities include hand and foot syndrome


Melphalan (Alkeran)

http://www.nlm.nih.gov/medlineplus/druginfo/meds/a682220.html

·      Tablets daily for 5 days every 4 to 5 weeks

·      May cause bone marrow suppression, mouth sores, or infrequent nausea, vomiting, and diarrhea

·      Dose-limiting toxicities include bone marrow failure


Oral Etoposide (VePesid)

http://www.nlm.nih.gov/medlineplus/druginfo/meds/a684055.html

·      Capsule given orally once a day for 2 to 3 weeks with 2 weeks off

·      May cause decrease in white and red blood cells/platelets, nausea and vomiting, loss of appetite, and complete hair loss

·      Dose-limiting toxicities include risk of secondary leukemia


Oxaliplatin (Eloxatin)

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000385

·      IV infusion for 48 hours (Eloxatin only given during first 2 hours) every 14 days as directed by doctor

·      May cause reduction in white and red blood cells and platelets, nausea and vomiting, diarrhea, mouth sores, or tingling and numbness in hands and feet


Paclitaxel (Taxol)

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000419

·      IV given over 30 minutes daily 5 days per week every 3 weeks or available in weekly doses

·      May cause reduction in white and red blood cells and platelets, numbness in hands and feet, nausea and vomiting, diarrhea and/or constipation, loss of appetite, and complete hair loss

·      Dose-limiting toxicities include nerve damage in hands and feet


Topotecan (Hycamtin)

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000992

·      IV daily for 30 minutes daily for 5 days a week every 3 weeks; alternative schedule: weekly

·      May cause moderate to severe reduction in white and red blood cells/platelets, nausea and vomiting, fever, headache, fatigue, or mild to moderate hair loss


Vinorelbine tartrate (Navelbine)

http://www.nlm.nih.gov/medlineplus/druginfo/meds/a695013.html

·      IV over 15-30 minutes weekly for 3 out of 4 weeks

·      May cause reduction of white blood cells, numbness and tingling in hands and feet, nausea and vomiting, or hair loss (uncommon)


HORMONES

Anastrozole (Armidex)

http://www.arimidex.com/

·      Tablet taken daily

·      May cause hot flashes, joint symptoms, weakness, mood changes, pain, sore throat/headache, nausea and vomiting, depression, high blood pressure, osteoporosis, or swelling of arms/legs


Letrozole (Femara)

http://www.femara.com/index.jsp

·      Tablet taken daily

·      May cause hot flashes, night sweats, nausea, tiredness, weight gain, vaginal bleeding, or joint pain


Tamoxifen citrate (Nolvadex)

·      Oral tablet or liquid taken daily

·      May cause hot flashes, changes in vision, infrequent rash, infrequent fluid retention, or risk for blood clotting




For more information about selecting a cancer treatment, visit:





REFERENCE

1. www.ovarian.org/assets/pdf/NOCC_Recurrent.pdf

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