Question asked by: 
Date asked: 
Jan 2016

My mum was diagnosed with a recurrence of ovarian cancer three weeks ago. She finished her initial chemo two years ago. Her oncologist has prescribed six cycles of carboplatin followed up by Tamoxifen. Do you have any experience of this combination? And why might she only have been prescribed the single chemo drug rather than have it combined with Taxol (which she had in first line treatment)?

Do you have any experience of the combination of carboplatin followed by Tamoxifen?
There is not yet conclusive evidence on the use of combination versus single agent chemotherapy
Response by Dr Simon Newman

As it's been  two years since her last treatment, it means her cancer is 'platinum sensitive' which means there is a greater chance it will respond to more platinum, which is why she's been offered carboplatin.

With regard to the use of combination v single agent chemo, there isn’t conclusive evidence either way.  In the NICE guidance on the use of Taxol it does state that if the patient has already received both drugs, the combination of paclitaxel and platinum-based therapy in recurrent (or resistant) ovarian cancer is not recommended, outside the context of clinical trials.

However, guidance on first line (on first diagnosis) use is that the decision on whether to have single agent or combination should be made after discussion between the clinician and the patient about the risks and benefits of the options available.  This discussion should cover the side-effects, the stage of the woman's disease, and the extent of the surgery.

With regard to tamoxifen, this is a hormone therapy best known for treatment in breast cancer. However, it can be useful in treating recurrence ovarian cancer, especially in women whose disease is slow growing.

We have a guide for women with recurrence ovarian cancer which you may benefit from reading. It’s called Back Here Again and covers treatment and the more psychosocial impact of a recurrence. You can download it here, or email us and we can send you a hard copy.