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Do we have a new standard in suboptimal debulked disease?
1University of Arizona Cancer Center, Tucson, USA.
Summary
Treatment options for high-risk advanced ovarian cancer are evolving. While suboptimal disease has decreased, recurrence risk remains high, necessitating individualized treatment and new non-platinum regimens.
Area of Science:
- Gynecologic Oncology
- Medical Oncology
- Clinical Trial Design
Background:
- High-risk advanced-stage ovarian cancer treatment landscape is dynamic.
- Evolving strategies include neoadjuvant chemotherapy (NACT), surgical timing, intraperitoneal (IP) chemotherapy, dose-dense paclitaxel, maintenance therapy, and bevacizumab.
Purpose of the Study:
- To review current and evolving treatment considerations for high-risk advanced-stage ovarian cancer.
- To highlight the need for individualized treatment strategies and innovative clinical trials.
Main Methods:
- Review of current treatment modalities and emerging strategies.
- Discussion of factors influencing treatment decisions, including clinical goals, toxicity, symptom control, and quality of life.
Main Results:
- The proportion of patients with suboptimal residual disease has decreased due to more aggressive surgery and patient selection for NACT followed by delayed surgery.
- Despite improvements, the risk of recurrence in this population remains high.
Conclusions:
- Individualized treatment decisions are crucial, balancing efficacy with toxicity and quality of life.
- Innovative trials are needed to identify early predictors of platinum resistance and develop alternative non-platinum regimens.
