The guidance does not recommend gemcitabine in combination with carboplatin, trabectedin in combination with PLDH or topotecan for treating the first recurrence of platinum-sensitive ovarian cancer – this is where the disease responds to first-line platinum-based therapy but returns after six months or more. Topotecan is also not recommended for treating cancer that has returned within six months of platinum treatment, or for cancer which did not respond to platinum treatment at all.