Dr. Hellmann on the Impact of Systemic Therapy on Surgery in Ovarian Cancer

Mira Hellmann, MD, gynecologic oncologist and assistant professor, Hackensack Meridian John Theurer Cancer Center at Hackensack University Medical Center, discusses the impact of surgery on patients with ovarian cancer.

Data recently determined that secondary cytoreductive surgery in patients who received prior therapy, particularly bevacizumab (Avastin), does not improve outcomes, explains Hellmann. Additionally, research looking at PARP inhibitors found that due to the effectiveness of PARP inhibitors in BRCA-positive patients with ovarian cancer, the role of secondary cytoreductive therapy is negligible, says Hellmann.

The more efficacious chemotherapy or targeted therapy is, the less surgical intervention is required to patients with ovarian cancer. The use of neoadjuvant chemotherapy to determine the tumor burden followed by interval surgery versus surgical debulking upfront presented equivalent outcomes; however, patients who receive chemotherapy upfront have less aggressive surgery, mortality, and morbidity, concludes Hellmann.