Second-line therapy of ovarian cancer with Paclitaxel administered by both the intravenous and intraperitoneal routes: rationale and case reports

Background: A strong rationale can be proposed to support the delivery of paclitaxel by both the intravenous and the intraperitoneal routes in the management of ovarian cancer. This includes efforts to increase the concentration and duration of exposure of this cycle-specific agent within the body compartment (regional therapy) and a desire to optimize delivery of drug to tumor by capillary flow (systemic therapy).

Case reports: Two patients cared for in the Gynecologic Cancer Program of the Cleveland Clinic Foundation provided an opportunity to explore, in a preliminary manner, the feasibility and toxicity of this unique approach. Both patients demonstrated reasonable tolerance of the dual-route management strategy.

Conclusion: In a carefully selected patient population, the administration of paclitaxel both systemically and regionally is a rational management strategy. Randomized controlled clinical trials will be required to determine if this approach is superior to standard intravenous drug delivery.