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Comparing Neoadjuvant Chemotherapy and Debulking Surgery in Advanced Tubo-Ovarian Cancers

By: Hillary Ojeda
Posted: Wednesday, December 19, 2018

Ignace Vergote, MD, PhD, of the Catholic University of Leuven, Belgium, and colleagues found no difference in the overall survival of patients treated with neoadjuvant chemotherapy versus upfront debulking surgery for advanced tubo-ovarian cancer. However, long-term follow-up data found that women with stage IV disease had better survival with neoadjuvant chemotherapy. The study findings were published in The Lancet Oncology.

The researchers analyzed individual patient data from the phase III EORTC 55971 and CHORUS trials, totaling 1,220 women. From the trials, 612 women were randomly selected for upfront debulking surgery followed by platinum-based chemotherapy. Additionally, 608 women were randomly selected for neoadjuvant platinum-based chemotherapy followed by interval debulking surgery followed by platinum-based chemotherapy.

The median follow-up was 7.6 years for all patients: 9.2 years for the EORTC trial and 5.9 years for the CHORUS trial. There was no difference noted in the median overall survival for the entire group who had neoadjuvant chemotherapy and upfront debulking surgery (27.6 months vs. 26.9 months, respectively). However, they did find that women with stage IV disease had better results with neoadjuvant chemotherapy than upfront debulking surgery (a median overall survival of 24.3 months vs. 21.2 months, respectively; and median progression-free survival of 10.6 months vs. 9.7 months, respectively).

“This pooled analysis, with long-term follow-up, shows that neoadjuvant chemotherapy is a valuable treatment option for patients with stage IIIC-IV tubo-ovarian cancer, particularly in patients with a high tumor burden at presentation or poor performance status,” Dr. Vergote and colleagues concluded.



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