Treatment protocols for gynecologic malignancies

INTRODUCTION — The following material represents a subset of chemotherapy and immunotherapy regimens that are used for the treatment of women with gynecologic cancers. This is not an exhaustive list; it includes regimens that are considered by the authors and editors to be commonly used and important for the care of patients with gynecologic cancers. Additional regimens may be added over time, particularly as treatment for gynecologic cancers evolve.

This topic review is intended to provide only a listing of chemotherapy and immunotherapy regimens. It does not address the appropriate context for use of these regimens in the care of patients with gynecologic cancer. Clinicians should refer to the individual disease-oriented topic reviews that discuss the use of these protocols in appropriate clinical situations:

Ovarian cancer

●(See "First-line chemotherapy for advanced (stage III or IV) epithelial ovarian, fallopian tube, and peritoneal cancer".)

●(See "Adjuvant therapy of early-stage (stage I and II) epithelial ovarian, fallopian tube, or peritoneal cancer".)

●(See "Medical treatment for relapsed epithelial ovarian, fallopian tube, or peritoneal cancer: Platinum-sensitive disease".)

●(See "Medical treatment for relapsed epithelial ovarian, fallopian tube, or peritoneal cancer: Platinum-resistant disease".)

Endometrial cancer

●(See "Overview of resectable endometrial carcinoma", section on 'Role of adjuvant therapy'.)

●(See "Adjuvant treatment of high-risk endometrial cancers".)

●(See "Management of locoregional recurrence of endometrial cancer".)

Cervical cancer

●(See "Management of locally advanced cervical cancer".)

●(See "Management of recurrent or metastatic cervical cancer".)

●(See "Small cell neuroendocrine carcinoma of the cervix", section on 'Treatment'.)

●(See "Invasive cervical adenocarcinoma".)

Uterine sarcoma

●(See "Clinical features, diagnosis, staging, and treatment of uterine carcinosarcoma".)

●(See "Treatment and prognosis of uterine leiomyosarcoma".)

●(See "Endometrial stromal sarcomas, related tumors, and uterine adenosarcoma".)

In addition, protocols for the treatment of women with sex cord stromal and germ cell tumors are covered separately.

●(See "Treatment protocols for germ cell tumors".)

These tables are provided as examples of how to administer these regimens; there may be other acceptable methods. All chemotherapy and immunotherapy regimens must be administered by clinicians who are trained in the use of chemotherapy and immunotherapy. The clinician is expected to use his or her independent medical judgment in the context of individual circumstances to make adjustments, as necessary.

REGIMENS

Regimens for ovarian cancer

BEP (bleomycin, etoposide, and cisplatin) —  (table 1)

Cisplatin plus paclitaxel —  (table 2)

Carboplatin plus paclitaxel —  (table 3)

Carboplatin plus pegylated liposomal doxorubicin —  (table 4)

Gynecologic Oncology Group (GOG) 172 regimen (intravenous [IV] paclitaxel followed by intraperitoneal [IP] cisplatin and IP paclitaxel) —  (table 5)

Weekly paclitaxel with every three week carboplatin —  (table 6)

Carboplatin and gemcitabine plus bevacizumab —  (table 7)

Regimens for endometrial cancer

Carboplatin plus paclitaxel —  (table 3)

Pembrolizumab monotherapy — This regimen may be administered with the oral agent, lenvatinib (table 8).

Regimens for cervical cancer

Etoposide plus cisplatin (EP) —  (table 9)

Cisplatin plus paclitaxel —  (table 2)

Carboplatin plus paclitaxel —  (table 3)

Pembrolizumab monotherapy —  (table 8)

Regimens for uterine sarcoma

Gemcitabine plus docetaxel —  (table 10)

Regimens for microsatellite instability-high cancer

Pembrolizumab monotherapy —  (table 8)

SOCIETY GUIDELINE LINKS — Links to society and government-sponsored guidelines from selected countries and regions around the world are provided separately. (See "Society guideline links: Treatment of cervical cancer" and "Society guideline links: Ovarian, fallopian tube, and peritoneal cancer" and "Society guideline links: Uterine cancer".)

ACKNOWLEDGMENT — The UpToDate editorial staff acknowledges Scott M Wirth, PharmD, BCOP, who contributed to an earlier version of this topic review.