Epithelial ovarian cancer (EOC) is the most common gynaecological malignancy in the Western world and a leading cause of death. Patients with relapsed EOC are incurable and therefore the toxicity of palliative chemotherapy and effects on health-related Quality of Life are important factors. Several newer cytotoxic agents have been used in these patients. Pegylated liposomal doxorubicin (Caelyx) has a different spectrum of activity from standard doxorubicin with response rates up to 25% in these patients and a low toxicity profile. In addition it is non cross resistant with platinum compounds. In a randomised phase III trial (n=474) of Caelyx versus Topotecan there were no significant differences in response rates, time to progression, overall survival or quality of life. Patients receiving Topotecan had more side effects requiring admission to hospital. Caelyx is a valuable therapy in platinum resistant patients with an efficacy equivalent to Topotecan but at a lower cost when side-effects and admission costs are included.
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