The predictors of response to neoadjuvant chemotherapy in advanced epithelial ovarian cancer

Abstract

To investigate the predictors of response to neoadjuvant chemotherapy (NACT) in advanced stage epithelial ovarian cancer (EOC). Thirty-five patients with nonoptimally cytoreductable at stage III-IV EOC who were treated with NACT and interval cytoreductive surgery in our center between January 2002 and February 2009 were enrolled into this retrospective pilot study. Response to NACT was evaluated according to Response Evaluation Criteria in Solid Tumors (RECIST). All patients received three courses platinum-based chemotherapy [24 (69%) received pactitaxel plus carboplatin and 11 (31%) received paclitaxel plus cisplatin]. There were 12 (34%) partial response to and 23 (66%) stable disease after NACT. Optimal cytoreduction was subsequently achieved in 32 of 35 patients (91%). Among age, hystology, ovarian size, CA-125 level, severity of pleural effusion, extensive omental disease, diaphragmatic implants, liver parenchyma metastasis, used chemotherapy regimen; only extensive omental disease was found to be predictive (P = 0.004). Ovarian cancer patients with extensive omental disease were possibly better treated with primary cytoreductive surgery, since they were more likely to have less responsive to NACT. This finding can be used to identify patients who will get poor response to NACT and to design future tailored randomized clinical trials.