Dr. Crafton on Considerations for Secondary Cytoreduction in Ovarian Cancer

Sarah Crafton, MD, gynecologic oncologist, Allegheny Health Network, discusses the personalized choice of undergoing secondary cytoreduction for patients with ovarian cancer.

Assessing the role of secondary cytoreduction has to be a personalized choice based on objective data from studies as well as patient preference, explains Crafton. Typically, these patients previously would undergo a primary cytoreductive surgery that may either influence them positively or negatively about aspiring to a second surgery, says Crafton. Therefore, a personalized conversation with the patient should take place.

The randomized phase III AGO DESKTOP III/ENGOT ov20 trial found a clinically meaningful progression-free survival (PFS) and time to first subsequent therapy (TFST) improvement with surgery over second-line chemotherapy in patients with first-relapse, AGO-positive ovarian cancer who had a platinum-free interval of ≥6 months. The median PFS was 19.6 months compared with 14.0 months (HR, 0.66; 95% CI, 0.52-0.83; P <.001), and median TFST was 21.0 months versus 13.9 months (HR, 0.61; 95% CI, 0.48-0.77; P <.001), showing results in favor of surgery. Data from this trial provide some criteria that can be used to direct counseling and patient selection for secondary cytoreduction, concludes Crafton.