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Neoadjuvant Chemotherapy for Ovarian Cancer

Panelists:Michael J. Birrer, MD, PhD, Mass General ; Robert A. Burger, MD, Fox Chase Cancer Center; Warner K. Huh, MD, UAB ; Maurie Markman, MD, CTCA ; James Tate Thigpen, MD, University of Mississippi School of Medicine
Published: Tuesday, Dec 30, 2014

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Current practice for the treatment of ovarian cancer involves primary de-bulking surgery followed by chemotherapy. Neoadjuvant chemotherapy, or the delivery of chemotherapy before surgery, tends to be used in patients who are not candidates for upfront de-bulking surgery, observes James Tate Thigpen, MD, and Robert A. Burger, MD.

Warner K. Huh, MD, notes that reliable preoperative markers that predict which individuals will have successful de-bulking are not available, and candidates for surgery are still largely based on comorbidities and performance status. If patients meet a certain threshold, they may be better served with neoadjuvant chemotherapy.

In clinical trials, the ability to de-bulk to no gross residual was greater in the neoadjuvant chemotherapy group. However, this cohort did not show a survival advantage. Moreover, de-bulking rates for primary de-bulking surgery ranged from 30% to 83%. Thigpen comments that the variable frequency in which patients achieve optimal de-bulking and the unclear data surrounding neoadjvaunt chemotherapy leaves him not yet comfortable simply choosing one approach over another.



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For High-Definition, Click
Current practice for the treatment of ovarian cancer involves primary de-bulking surgery followed by chemotherapy. Neoadjuvant chemotherapy, or the delivery of chemotherapy before surgery, tends to be used in patients who are not candidates for upfront de-bulking surgery, observes James Tate Thigpen, MD, and Robert A. Burger, MD.

Warner K. Huh, MD, notes that reliable preoperative markers that predict which individuals will have successful de-bulking are not available, and candidates for surgery are still largely based on comorbidities and performance status. If patients meet a certain threshold, they may be better served with neoadjuvant chemotherapy.

In clinical trials, the ability to de-bulk to no gross residual was greater in the neoadjuvant chemotherapy group. However, this cohort did not show a survival advantage. Moreover, de-bulking rates for primary de-bulking surgery ranged from 30% to 83%. Thigpen comments that the variable frequency in which patients achieve optimal de-bulking and the unclear data surrounding neoadjvaunt chemotherapy leaves him not yet comfortable simply choosing one approach over another.
View Conference Coverage
Online CME Activities
TitleExpiration DateCME Credits
Community Practice Connections™: Redefining Ovarian Cancer Treatment Paradigms by Maximizing Therapeutic Outcomes with PARP InhibitorsSep 29, 20182.0
Community Practice Connections™: 1st Annual School of Nursing Oncology™Oct 31, 20181.5
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