Advanced ovarian cancer: the case for personalized treatment

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Takeaway
  • Primary debulking surgery (PDS) was associated with improved outcomes, and neoadjuvant chemotherapy (NACT) may improve survival in those with residual disease after PDS.
Why this matters
  • Not all patients with stage III or IV ovarian cancers benefit from 1 standard approach, PDS or NACT, and criteria to optimize patient selection are needed.
Study design
  • Retrospective study that included 263 patients treated for stage III-IV ovarian cancers between 2003 and 2015 at an academic medical center.
  • Funding: Montreal-Israel Cancer Research Foundation; Gloria Shapiro Fund; Weekend to End Women Cancers; Levy Family Fund; Astra Zeneca Inc.
Key results
  • Improved PFS and OS were observed after PDS vs NACT.
  • PDS patients with no residual disease after surgery had significantly better OS and PFS vs all other groups (P-values=.001); the opposite was observed for NACT patients with residual disease after interval debulking surgery.
  • NACT patients with complete cytoreduction had better OS and PFS vs PDS patients who did not achieve complete cytoreduction.
  • Results do not support an association of NACT with increased risk of developing platinum resistance.
Limitations
  • Retrospective and single-center design.