BACKGROUND & OBJECTIVE: The therapeutic principle of ovarian cancer was cytoreductive surgery assisting with chemotherapy. At present, cisplatin-based chemotherapy is the primary way for treatment of ovarian cancer. But most patients with advanced ovarian cancer were easy to recurrent and then become resistance to cisplatin. This study was designed to evaluate the clinical application of topotecan in recurrent ovarian cancer and ovarian cancer resistant to cisplatin. METHODS: An adenosine triphosphate chemosensitivity assay (ATP-CSA) was used to determine the drug sensitivity of 41 tissue specimens of fresh ovarian cancer. Cisplatin and topotecan were used as chemotherapeutic agents [1xPeak Plasma Concentration (PPC)], and then the results were analyzed. RESULTS: (1) In 41 specimens, the results showed that topotecan was more sensitive (80.5%) than cisplatin (51.2%). (2) In 20 cisplatin-resistance specimens, there were 18 specimens sensitive to topotecan. CONCLUSIONS: Topotecan could be a kind of better second line drug in treating ovarian cancer, particularly when the patient was resistant to cisplatin.