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Decisions about the treatment of recurrent ovarian cancer are usually based on the treatment-free interval. Patients relapsing with an interval of more than six months are usually retreated with platinum-based chemotherapy. Non platinum drugs (such as paclitaxel, gemcitabine, liposomal doxorubicin or topotecan) are also active in relapsed disease. A high response rate is consistently seen with combinations of platinum and these drugs in phase II trials. ICON 4, the first large-scale randomised trial in 'platinum-sensitive' relapsed ovarian cancer demonstrated a survival benefit for using platinum-based therapy in combination with paclitaxel. More studies are needed to explore other combinations of treatment in this group of women as the choice and timing of second-line therapy needs to take account of the benefits and toxicity of treatment. [ABSTRACT FROM AUTHOR]