Unfortunately, available data fail to provide evidence for the legitimate curative potential of any existing second-line chemotherapeutic strategy in ovarian cancer.2,7-11 This is an important point and clearly distinguishes secondary from primary treatment, where it is rational to suggest that such treatment is being delivered to many patients with curative intent, even if only a limited percentage of individuals ultimately achieve this goal.1,2
In the absence of "cure" as an aim of treatment, what are the overall goals of second-line treatments in ovarian cancer? There are a number of highly clinically relevant objectives of such therapy, as outlined in Box 9-3. A critically important aspect of anticancer management in this setting is to carefully balance the meaningful goals of therapy with the potential adverse effects of treatment, particularly when certain toxicities may be cumulative and persistent in their impact on an individual's quality of life (e.g., neuropathy).
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