The combination of topoisomerase-I and topoisomerase-II inhibitors is an attractive strategy for cancer chemotherapy. A phase II study evaluated the combination of pegylated liposomal doxorubicin 30mg/m2/week with topotecan 1 mg/m2 IV for 5 consecutive days given every 28 days. Twelve patients with platinum resistant ovarian cancer were treated. Partial response was observed in three patients and four patients had stable disease of the ten patients evaluated for response. Toxicities included a higher percentage of bone marrow toxicity (grade III/IV neutropenia, grade III/IV thrombocytopenia) other toxicities included alopecia and diarrhea grade II/III. The authors concluded that the combination of topotecan and pegylated liposomal doxorubicin is active in the treatment of platinum resistant ovarian cancer. However, myelosuppression required dose reductions in nearly half the patients.