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Platinum-based chemotherapy — sometimes simply called “platinum therapy” — is commonly used to treat advanced ovarian cancer, fallopian tube cancer, and primary peritoneal cancer. How well the cancer responds to this treatment helps doctors determine the best options for your next steps in care.
Platinum-based chemotherapy includes drugs that contain the chemical element platinum. The two most commonly used platinum drugs for ovarian cancer are cisplatin and carboplatin.
Cisplatin and carboplatin work by damaging a cell’s DNA, which contains the cell’s genes. When the DNA is damaged, the cells can’t divide and grow, so they eventually die.
Platinum drugs are usually given through an IV (into a vein). In some cases, they may also be given directly into the abdomen (called intraperitoneal chemotherapy). This approach is sometimes used for people with stage 3 ovarian cancer that has spread outside the pelvis, especially if most of the tumor was removed during a procedure called debulking surgery.
People with advanced ovarian cancer typically receive platinum-based chemotherapy after surgery. These drugs are often combined with a second type of chemotherapy called taxanes, such as paclitaxel. Targeted therapies may also be added. For people with stage 4 cancer that has spread more widely, platinum drugs may also be given before surgery to help shrink tumors.
Many clinical trials over the past few decades have shown that platinum drugs combined with paclitaxel work well as a first-line — or front-line — treatment for ovarian cancer. “Front-line therapy” refers to the initial treatment given after diagnosis to help control the cancer.
Platinum-based chemotherapy doesn’t work for everyone. In particular, advanced-stage ovarian cancer can be difficult to treat. There are a couple of situations in which cancer may return or continue growing, despite platinum therapy. Relapsed or recurrent ovarian cancer seems to go away after it’s treated, but the cancer later returns. Resistant ovarian cancer can’t be adequately controlled by a particular treatment and no response can be observed even after treatment.
Response to treatment can be measured in a few ways. A complete response means that all signs of cancer disappear. This is usually determined through imaging tests, such as a computed tomography (CT) or positron emission tomography (PET) scan. But this doesn’t necessarily mean that the cancer won’t come back. A partial response means that a tumor shrinks or signs of cancer lessen but don’t fully go away.
According to the Gynecologic Cancer InterGroup, there are four categories of ovarian cancer. Each is based on the disease’s response to platinum therapy and when disease progression occurs:
Between 60 percent and 80 percent of cases of high-grade serous carcinoma — the most common type of ovarian cancer — at first respond well to platinum therapy. But this cancer almost always becomes resistant and recurs after treatment.
Other types of ovarian cancer that are most likely to be platinum-resistant include clear cell, mucinous, and low-grade serous carcinoma.
Ovarian cancer’s response to platinum therapy provides information about which treatments should be tried next. Doctors may recommend different treatment plans based on whether a case of ovarian cancer is sensitive, resistant, or refractory to platinum-based drugs.
Platinum-based chemotherapy may successfully kill enough cancer cells to cause signs of ovarian cancer to disappear and stay away for a long time. This is a sign that the cells are at least partially sensitive to these drugs. Doctors may recommend using the same chemotherapy drugs that were used the first time around because they’re likely to work again.
Carboplatin often works very well to treat platinum-sensitive cancer, even after it returns. However, after being treated a second time, the cancer may come back again. It may return more quickly each time, until it’s eventually classified as platinum-resistant ovarian cancer.
If you have platinum-sensitive recurrent ovarian cancer, ask your doctor about the pros and cons of using another round of platinum therapy. The drugs may work well, but they also come with a lot of side effects that can reduce your quality of life.
Cancer of the ovary that returns soon after treatment with first-line chemotherapy may need a different treatment option. Overall, more than 80 percent of people with advanced ovarian cancer experience a relapse, often within two years of beginning treatment.
If you have resistant disease, your doctor might suggest giving platinum therapy another try. But they may recommend moving on to a different treatment plan. The next regimen often includes other chemotherapy drugs that don’t contain platinum, such as:
These chemotherapies generally lead to similar outcomes. Your oncologist may recommend one of these medications based on factors like your overall health, presence of comorbidities, side effects, cost, convenience of accessing treatments, and which therapies you’ve received in the past.
Your doctor may also recommend targeted therapy or immunotherapy drugs such as bevacizumab (Avastin) and pembrolizumab (Keytruda) that target cancer cells and prevent them from growing.
Targeted treatment options include drugs called PARP inhibitors. PARP stands for poly (ADP-ribose) polymerase — a protein that some ovarian cancer cells rely on to repair DNA damage. If your cancer cells have mutations (changes) in the BRCA genes, they require PARP to keep growing. PARP inhibitors can block PARP without affecting healthy cells.
PARP inhibitors available to treat ovarian cancer as of April 2025 include:
PARP inhibitors are typically prescribed to be taken orally (by mouth) every day.
Antibody drug conjugates (ADCs) are a newer type of targeted therapy. These drugs identify, target, and destroy specific ovarian cancer cells. Because ADCs are targeted just toward the cancerous cells, they cause fewer side effects than chemotherapy.
One ADC is called mirvetuximab soravtansine-gynx (Elahere). This drug was approved in 2024 to treat platinum-resistant epithelial ovarian cancer, peritoneal cancer, or fallopian tube cancer.
When first-line treatments don’t work at all and the cancer keeps growing, there’s a higher chance that the cancer cells won’t respond to any drugs. This type of ovarian cancer is very difficult to treat.
If you have platinum-refractory ovarian cancer, work with your doctor to explore the benefits and risks of different treatment options. Your doctor may suggest seeing if some type of targeted therapy or chemotherapy regimen will control your cancer. The treatments that work best for you depend on your overall health and personal preferences.
Joining a clinical trial may be a good option for people with platinum-refractory disease. By participating in a study, you may be able to access a new type of drug or procedure that you couldn’t normally get through your oncologist.
For example, researchers have identified many genes that affect whether cancer cells are sensitive or resistant to platinum. Clinical trials have looked into whether drugs that target these genes may help treat ovarian cancer. Ask your oncologist if there are any clinical trials available for your case.
Some people with platinum-refractory ovarian cancer may choose to not treat the cancer and instead rely on palliative or hospice care. Palliative care helps treat advanced ovarian cancer symptoms and meet the physical, emotional, and spiritual needs of a person with cancer and their loved ones. It can be used during any cancer stage, with or without other treatments that aim to cure the cancer.
Hospice care, on the other hand, helps improve comfort and well-being at the end of a person’s life. Keep in mind that relying on palliative or hospice care is never the wrong option and depends entirely on you and your family’s wishes.
Making treatment decisions can be very complex. Many people find that they’re happier with their cancer care when they engage in shared decision-making with their doctor. During this process, a person with cancer is informed about the potential benefits and risks of different treatment options. The doctor takes into account the person’s preferences and values.
Ultimately, you and your family will decide on the best treatment plan suited to your personal needs and situation, with your doctor guiding you in making this important decision.
It’s always OK to ask for more information and keep asking questions when the information you’re given doesn’t make sense to you. You may want to do some reading about different treatment options on your own and write down questions to take to your medical appointments. For example, you could ask your doctor whether your cancer is sensitive or resistant to platinum therapy and what that means for your future treatments.
MyOvarianCancerTeam is the social network for people with ovarian cancer and their loved ones. On MyOvarianCancerTeam, more than 7,000 members come together to ask questions, give advice, and share their stories with others who understand life with ovarian cancer.
Did your doctor discuss with you how your ovarian cancer responded to platinum therapy? Do you still have questions about what this means for your future treatment options? Share your experiences in the comments below, or start a conversation by posting on your Activities page.
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A MyOvarianCancerTeam Member
I start Lynparza in June! I’m a little nervous! Seeing your post makes me even more hesitant! I haven’t seen that article! Maybe I should question my oncologist!