Chemotherapy for Ovarian Cancer: An Overview

While this may remain standard across most women with ovarian cancer, what differs significantly based on the unique case is the timing at which the chemotherapy is administered and in how many cycles it is given.

Many women, for instance, will receive chemotherapy after surgery, and will receive about six cycles of it. Other women may need to have three or four cycles of chemo prior to their surgery — called “neoadjuvant chemotherapy” — followed by additional chemo given after surgery.

The timing, frequency, and dose of chemotherapy should all be decisions that you and your oncologist will make together.

What About Side Effects?

As far as side effects, women should expect to feel more tired than usual, but Dr. Yvette Williams-Brown, a gynecologic oncologist at the LIVESTRONG Cancer Institutes at UT Health Austin, says she advises women to continue to try to maintain a normal routine insofar as they can.

“I advise patients that whatever they were doing before chemotherapy, they can reasonably do that during and after chemotherapy,” says Dr. Williams-Brown. “So that would include things such as work and exercise.”

Having said that, Dr. Williams-Brown also adds that many patients may need some time off to recover and rest during the cycles of chemo, which is why it can be helpful to plan for a flexible schedule in case you are feeling too great some days.

What if Chemo Doesn’t Work?

Ovarian cancer can be really difficult to treat and often comes back even after a successful treatment. When it does return, it may be more aggressive and resistant to traditional platinum-based chemotherapies.

For some women, a promising new treatment called Elahere (generic name mirvetuximab soravtansine) may be an option. Elahere was given emergency approval by the Food and Drug Administration (FDA) in 2023. It is a unique drug that is part antibody and part chemotherapy.

Phase III clinical trials showed that the drug was effective at treating some patients who had become resistant to platinum-based chemotherapies.

The drug targets the folate receptor alpha (FRα) protein present on the tumor cell surface. Up to 80% of new and recurrent ovarian cancers may carry this protein (FRα levels tend to be higher in more aggressive ovarian cancers).

The accelerated approval was based on a rigorous clinical trial called SORAYA, which showed effectiveness at suppressing cancer growth in at least one-third of patients. The drug is expected to be given full approval in the U.S. after promising new data from another trial, MIRASOL, was released in May 2023.

The findings indicate that patients with ovarian cancer should speak to their doctors about testing for the FRα protein and see if they are eligible for this ground-breaking new treatment.

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