Abstract
Background: This study aims to provide guidance for the use of neoadjuvant and adjuvant systemic therapy in women with newly diagnosed stage II–IV epithelial ovary, fallopian tube, or primary peritoneal carcinoma. Methods: EMBASE, MEDLINE, and Cochrane Library were investigated for relevant systematic reviews and phase III trials. Articles focusing on consolidation and maintenance therapies were excluded. Results: For women with potentially resectable disease, primary cytoreductive surgery, followed by six to eight cycles of intravenous three-weekly paclitaxel and carboplatin is recommended. For those with a high-risk profile for primary cytoreductive surgery, neoadjuvant chemotherapy can be an option. Adjuvant chemotherapy with six cycles of dose-dense weekly paclitaxel plus three-weekly carboplatin can be considered for women of Japanese descent. In women with stage III or IV disease, the incorporation of bevacizumab concurrent with paclitaxel and carboplatin is not recommended for use as adjuvant therapy unless bevacizumab is continued as maintenance therapy. Intravenous paclitaxel plus intraperitoneal cisplatin and paclitaxel can be considered for stage III optimally debulked women who did not receive neoadjuvant chemotherapy. However, intraperitoneal administration of chemotherapy with bevacizumab should not be considered as an option for stage II–IV optimally debulked women. Discussion: The recommendations represent a current standard of care that is feasible to implement and valued by both clinicians and patients.
Highlights
Diagnosed ovarian cancer most commonly presents with disease that is already at an advanced stage
Further research is required to provide treatment guidance for different histological types or molecular subsets in the target population]; (6) Discussion on BRCA-HRD status as part of the decision-making assessment of the whole therapeutic strategy should be included. [Response: Only one post hoc analysis examined the prognostic relevance of BRCA1 expression [9]
Women with aberrant BRCA1 expression had increased overall survival (OS) when treated with i.p. chemotherapy
Summary
Diagnosed ovarian cancer most commonly presents with disease that is already at an advanced stage. The Working Group of the Ovarian Cancer Guideline Development Group, in association with the Program in Evidence-Based Care (PEBC) of Ontario Health (Cancer Care Ontario), intended to develop this clinical practice guideline to make recommendations on the most effective regimen to administer systemic therapy for women with newly diagnosed stage II, III or IV epithelial ovary, fallopian tube, or primary peritoneal carcinoma (EOC) in the neoadjuvant/adjuvant setting This process includes a systematic review, interpretation of the evidence and draft recommendations by the Working Group, internal review by content and methodology experts, and external review by Ontario clinicians and other stakeholders. Adjuvant chemotherapy with six cycles of dose-dense weekly paclitaxel plus three-weekly carboplatin can be considered for women of Japanese descent
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
