Another concept, maintenance therapy, has been studied and debated among investigators over the last 5 years. Maintenance therapies focus on extending the duration of frontline treatment. There have been several reports concerning cytotoxic chemotherapy, hormonal therapy, and immunotherapy used in this manner.68-70 In 2003, a GOG trial demonstrated that maintenance paclitaxel given every 4 weeks for 12 months to patients in complete remission following standard intravenous pacli-taxel-carboplatin significantly increased the progression-free survival by 7 months compared with maintenance therapy for 3 months.71 This study's value has been controversial owing to lack of overall survival data following early closure by the data monitoring committee. Nonetheless, this was a significant improvement for these patients, some of whom began therapy with bulky, suboptimal disease; therefore, maintenance therapy should be a discussion point with patients with advanced epithelial ovarian cancer. Currently, GOG 212 is further investigating this concept in a randomized three-arm study comparing 12 months of paclitaxel versus xyotax versus observation following complete clinical response to frontline platinum/taxane treatment.
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