| Evolent Pathways | Febrile Neutropenic Risk | Emetogenic Risk | References | |
|---|---|---|---|---|
Neoadjuvant (before surgery) or Adjuvant (after surgery) |
cisplatin and paclitaxel |
Low | Moderate |
|
cisplatin and docetaxel |
Intermediate | High |
|
|
carboplatin and paclitaxel |
Low | High |
|
|
carboplatin and docetaxel |
Intermediate | Moderate |
|
|
Primary Therapy for Stage II–IV Disease |
carboplatin and paclitaxel |
Low | High |
|
Maintenance post primary chemotherapy |
niraparib |
Low | High |
|
olaparib *BRCA mutation* |
Low | Moderate |
|
|
Recurrence Therapy for Platinum-Sensitive Disease |
cisplatin and paclitaxel |
Low | High |
|
cisplatin and docetaxel |
Intermediate | High |
|
|
carboplatin and Doxil (liposomal doxorubicin) |
Low | High |
|
|
cisplatin and Doxil (liposomal doxorubicin) |
Low | High |
|
|
cisplatin and gemcitabine |
Low | High |
|
|
Maintenance post recurrence chemotherapy |
niraparib *BRCA mutation* |
Low | High |
|
olaparib *BRCA mutation* |
Low | Moderate |
|
|
Recurrence Therapy for Platinum-Resistant Disease |
gemcitabine |
Low | Low |
|
topotecan |
Intermediate | Low |
|
|
paclitaxel |
Low | Low |
|
|
docetaxel |
Intermediate | Low |
|
|
Doxil (liposomal doxorubicin) |
Low | Low |
|
|
pembrolizumab and paclitaxel without bevacizumab (CPS ≥ 1) |
Low | Low |
|
|
mirvetuximab soravtansine-gynx (folate receptor alpha expressing tumors [≥75% positive tumor cells]) |
Low | Low |
|
|
fam-trastuzumab deruxtecan-nxki (for HER2 positive [IHC 3+ or 2+]) |
High | High |
|
|
Best Supportive Care |
Not Applicable | Not applicable |
|
Neoadjuvant (before surgery) or Adjuvant (after surgery)
cisplatin and paclitaxel
cisplatin and docetaxel
carboplatin and paclitaxel
carboplatin and docetaxel
Primary Therapy for Stage II–IV Disease
carboplatin and paclitaxel
Maintenance post primary chemotherapy
niraparib
olaparib *BRCA mutation*
Recurrence Therapy for Platinum-Sensitive Disease
cisplatin and paclitaxel
cisplatin and docetaxel
carboplatin and Doxil (liposomal doxorubicin)
cisplatin and Doxil (liposomal doxorubicin)
cisplatin and gemcitabine
Maintenance post recurrence chemotherapy
niraparib *BRCA mutation*
olaparib *BRCA mutation*
Recurrence Therapy for Platinum-Resistant Disease
gemcitabine
topotecan
paclitaxel
docetaxel
Doxil (liposomal doxorubicin)
pembrolizumab and paclitaxel without bevacizumab (CPS ≥ 1)
mirvetuximab soravtansine-gynx (folate receptor alpha expressing tumors [≥75% positive tumor cells])
fam-trastuzumab deruxtecan-nxki (for HER2 positive [IHC 3+ or 2+])
Best Supportive Care
| Regimen | Alternative | References | |||
|---|---|---|---|---|---|
| LOW VALUE REGIMENS (NON-PATHWAY) WITH SUPERIOR ALTERNATIVES | |||||
Recurrence Therapy |
** niraparib or olaparib or rucaparib ** |
Alternative: carboplatin + paclitaxel or any other single agent not previously used |
|||
** albumin-bound paclitaxel (Abraxane) ** |
Alternative: paclitaxel |
|
|||
** relacorilant and albumin-bound paclitaxel (Abraxane) ** |
Alternative: Other targeted therapies eg mirvetuximab for FRα expressing tumors, pembrolizumab + paclitaxel for CPS≥1 |
||||
Recurrence Therapy
** niraparib or olaparib or rucaparib **
** albumin-bound paclitaxel (Abraxane) **
** relacorilant and albumin-bound paclitaxel (Abraxane) **