EditorialNeoadjuvant chemotherapy in advanced ovarian cancer: What kind of evidence is needed to convince US gynaecological oncologists?
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Conflict of interest statement
The authors has no conflict of interest to declare.
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Anti-cancer therapy and clinical trial considerations for gynecologic oncology patients during the COVID-19 pandemic crisis
2020, Gynecologic OncologyCitation Excerpt :While NACT can avoid many of these challenges, it does require a biopsy for pathologic confirmation, and chemotherapy will still result in an immunocompromised state. Randomized phase 3 trials, including EORTC and CHORUS, demonstrated that NACT is not inferior to primary surgical cytoreduction with respect to overall and progression-free survival, with lower morbidity [4,5]. NACT in patients with advanced stage disease is a viable alternative to PDS when resources for surgical intervention are restricted during the pandemic crisis.
Review of methodological challenges in comparing the effectiveness of neoadjuvant chemotherapy versus primary debulking surgery for advanced ovarian cancer in the United States
2018, Cancer EpidemiologyCitation Excerpt :However, it is unclear whether NACT provides a survival benefit. In the U.S., the role of NACT in advanced ovarian cancer remains controversial [23–29]. Although two randomized controlled trials (RCTs) outside the U.S. observed non-inferior survival with NACT versus PDS [10,30], the generalizability of these trials to U.S. practice has been questioned due to lower median overall survival and lower rates of optimal debulking compared to U.S. populations [28,29].
Meigs to modern times: The evolution of debulking surgery in advanced ovarian cancer
2018, Gynecologic OncologyRapid selection of BRCA1-proficient tumor cells during neoadjuvant therapy for ovarian cancer in BRCA1 mutation carriers
2017, Cancer LettersCitation Excerpt :Among 6 tumors with the retention of BRCA1 heterozygosity in the chemonaive tumor tissue, 4 patients (67%) demonstrated a good histopathologic response (Table 1). The utility of the neoadjuvant therapy for the treatment of ovarian cancer is a subject of intense debates [16–21]. The preoperative use of platinum agents usually results in significant reduction of tumor volume, thus allowing for a less traumatic surgery and a low perioperative morbidity.
Surgery for advanced epithelial ovarian cancer
2017, Best Practice and Research: Clinical Obstetrics and GynaecologyCitation Excerpt :As in the EORTC-NCIC study, the rate of optimal cytoreduction was low in the primary surgical arm (only 41% of patients were cytoreduced to ≤ 1 cm), and the median overall 3-year survival in each group was only 22-24 months. The comparable survival and lower morbidity and mortality in the NACT group has led some in the gynaecological oncology community, particularly in Europe, to conclude that NACT should be regarded as the treatment of choice [41,42]. However, the studies have been criticized, particularly on the basis that most of the patients received poor standard surgery, and that the progression-free and overall survivals were substantially lower than expected.