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Chemotherapy (chemo) is the use of drugs to treat cancer. For ovarian cancer, chemo is used to:
Most of the time, chemo uses drugs that are injected into a vein (IV) or given by mouth. These are systemic treatments, meaning the drugs enter the bloodstream and reach almost all areas of the body.
In some cases, chemotherapy may also be injected through a catheter (thin tube) directly into the abdominal cavity. This is called intraperitoneal (IP) chemotherapy.
Chemo for ovarian cancer usually involves getting two different types of drugs together. Getting a combination of drugs instead of just one drug alone seems to work better as a first treatment for ovarian cancer.
Some of the chemo drugs used in treating ovarian cancer include:
Usually, the combination includes a type of chemo drug called a platinum compound (usually cisplatin or carboplatin), and another type of chemo drug called a taxane, such as paclitaxel (Taxol) or docetaxel (Taxotere). These drugs are usually given as an IV (put into a vein) every 3 to 4 weeks.
The typical course of chemo for epithelial ovarian cancer involves 3 to 6 cycles of treatment, depending on the stage and type of ovarian cancer. A cycle is a schedule of regular doses of a drug, followed by a rest period. Different drugs have varying cycles; your doctor will let you know what schedule is planned for your chemo.
Epithelial ovarian cancer often shrinks or even seems to go away with chemo, but the cancer cells may eventually begin to grow again. If the first chemo seemed to work well and the cancer stayed away for at least 6 to 12 months, it can be treated with the same chemotherapy used the first time. In some cases, different drugs may be used.
For stage III ovarian cancer (cancer that has not spread outside the abdomen) that has been optimally debulked (no tumors larger than 1 cm after surgery), intraperitoneal (IP) chemotherapy might be given in addition to systemic chemo (paclitaxel given in a vein).
In IP chemotherapy, the drugs cisplatin and paclitaxel are injected into the abdominal cavity through a catheter (thin tube). The tube can be placed during the staging/debulking surgery, or later, either by a surgeon using laparoscopy or by an interventional radiologist under x-ray guidance. The catheter is usually connected to a port, a half dollar-sized disk topped with a pliable diaphragm. The port is placed under the skin against a bony structure of the abdominal wall, such as a rib. A needle is placed through the skin and into the port to give chemo and other drugs.
IP chemo gives the most concentrated dose of the drugs directly to the cancer cells in the abdominal cavity. This chemo also gets absorbed into the bloodstream and so can reach cancer cells outside the abdominal cavity.
IP chemotherapy seems to help some women live longer than IV chemo alone, but the side effects are often more severe. It can cause more abdominal pain, nausea, vomiting, and other side effects, which might make some women stop their treatment early. Because of these risks, IP chemo is usually only done if you:
If you have a germ cell tumor, you will likely be treated with combination chemo (several different drugs at once). BEP (bleomycin, etoposide, and cisplatin) is the combination used most often.
If the cancer is a dysgerminoma, these are usually very sensitive to chemotherapy and can sometimes be treated with the less toxic combination of carboplatin and etoposide.
Other drug combinations may be used if the cancer isn’t responding to treatment or to treat cancer that has recurred (come back). These include:
Ovarian stromal tumors are not often treated with chemotherapy, but when they are, the combination of carboplatin plus paclitaxel or EP (etoposide and cisplatin) is used most often.
Chemo drugs can cause side effects. These depend on the type and dose of drugs given, and the length of treatment. Common side effects include:
Chemo can also affect the blood-forming cells of the bone marrow, which can lead to:
These side effects usually go away after treatment is finished. While you are in treatment, tell your cancer care team about any side effects that you are having. There are often ways to lessen these side effects. For example, drugs can be given to help prevent or reduce nausea and vomiting.
Some chemo drugs may have long-term or even permanent side effects:
Other drugs can have other side effects, so ask your doctor what side effects to expect from the treatments you will receive.
Most side effects improve once treatment is stopped, but some can last a long time and may never go away completely.
New chemotherapy (chemo) drugs and drug combinations are being tested.
When the drugs cisplatin and carboplatin stop working, the cancer is said to be platinum resistant. Studies are looking for many ways to make these cancers sensitive to these drugs again. Different strategies include:
For more general information about how chemotherapy is used to treat cancer, see Chemotherapy.
To learn about some of the side effects listed here and how to manage them, see Managing Cancer-related Side Effects.
Developed by the American Cancer Society medical and editorial content team with medical review and contribution by the American Society of Clinical Oncology (ASCO).
Aghajanian C, Blank SV, Goff BA, et al. OCEANS: A randomized, double-blind, placebo-controlled phase III trial of chemotherapy with or without bevacizumab in patients with platinum-sensitive recurrent epithelial ovarian, primary peritoneal, or fallopian tube cancer. J Clin Oncol 2012;30:2039-2045.
Cannistra SA, Gershenson DM, Recht A. Ch 76 - Ovarian cancer, fallopian tube carcinoma, and peritoneal carcinoma. In: DeVita VT, Hellman S, Rosenberg SA, eds. Cancer: Principles and Practice of Oncology. 10th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2015.
Gourly C, Walker JL, Mackay HJ. Update on Intraperitoneal Chemotherapy for the Treatment of Epithelial Ovarian Cancer. Am Soc Clin Oncol Educ Book. 2016;35: 143-51.
National Comprehensive Cancer Network (NCCN)--Ovarian Cancer Including Fallopian Tube Cancer and Primary Peritoneal Cancer. V2.2025. Accessed May 20, 2025 from https://www.nccn.org/professionals/physician_gls/pdf/ovarian.pdf
Parmar MK, Ledermann JA, Colombo N, et al. Paclitaxel plus platinum-based chemotherapy versus conventional platinum-based chemotherapy in women with relapsed ovarian cancer: the ICON4/AGO-OVAR-2.2 trial. Lancet 2003;361:2099-2106.
Pfisterer J, Dean AP, Baumann K, et al. Carboplatin/pegylated liposomal doxorubicin/bevacizumab (CD-BEV) vs. carboplatin/gemcitabine/bevacizumab (CGBEV) in patients with recurrent ovarian cancer. A prospective randomized phase III ENGOT/GCIG-Intergroup study (AGO Study Group, AGO-Austria, ANZGOG, GINECO, SGCTG). Presented at: 2018 ESMO Congress; October 19-23, 2018; Munich, Germany. Abstract 933O.
Pfisterer J, Plante M, Vergote I, et al. Gemcitabine plus carboplatin compared with carboplatin in patients with platinum-sensitive recurrent ovarian cancer: an intergroup trial of the AGO-OVAR, the NCIC CTG, and the EORTC GCG. J Clin Oncol 2006;24:4699-4707.
Pujade-Lauraine E, Wagner U, Aavall-Lundqvist E, et al. Pegylated liposomal doxorubicin and carboplatin compared with paclitaxel and carboplatin for patients with platinum-sensitive ovarian cancer in late relapse. J Clin Oncol 2010;28:3323-3329.
Last Revised: August 8, 2025
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