Research has shown that platinum based combinations are superior to non-platinum containing regimens. Two platinum compounds are used in ovarian cancer and appear to have largely equivalent therapeutic efficacy, cisplatin and carboplatin. Among the various combination regimes tested it was found that two drug combination of cisplatin plus cyclophosphamide had been considered to be the treatment of choice. Recent studies indicated that carboplatin might replace cisplatin as the platinum complex of choice.  Carboplatin is a second generation platinum coordination compound. It is less nephrotoxic, neurotoxic, and emetogenic than cisplatin but with more marked myelosuppression, particularly thrombocytopenia.

Determination of tumour response to chemotherapy can often be difficult as abdominal masses are often indistinct and CT scanning may be useful only for hepatic metastases or large nodal masses. Serum CA125 tumour marker has been found to accurately mirror the response to therapy of ovarian cancers and can help to determine the effectiveness of therapy.

Many patients who have had a previous good response to cisplatin or carboplatin based therapy can be treated again with the same agent and further meaningful response can result

For patients who relapse with cisplatin or carboplatin, Taxol is often appropriate. Taxol is a diterpene plant product. It is cytotoxic on microtubule assembly and on prevention of tubular depolymerisation. The most common side effects are total alopecia, myelo-supression, muscle aches and peripheral neuropathy. Many patients find Taxol treatment easier to tolerate than cisplatin based therapy because of the absence of gastrointestinal side effects.

Other drugs that can be used are oral hexamethylmelamine, mitoxantrone, oral VP.16, and Ifosfamide.