Dr. Horowitz on Frontline Strategies in Newly Diagnosed Ovarian Cancer

Neil Horowitz, MD, director of Clinical Research in Gynecologic Oncology, assistant professor of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, Dana-Farber Cancer Institute, discusses frontline strategies in the treatment of patients with newly diagnosed advanced ovarian cancer.

Neoadjuvant chemotherapy followed by interval debulking surgery and primary debulking surgery are options for patients with newly diagnosed advanced ovarian cancer. Although the ongoing TRUST trial is comparing these 2 approaches, it remains unclear whether one approach is superior to the other. As a result, determining which approach to proceed with often comes down to the surgeon’s preference, says Horowitz. However, surgeons are starting to incorporate diagnostic laparoscopies into a patient’s workup as a way to predict or understand who would be able to receive an optimal cytoreduction.

Women who are clear candidates for neoadjuvant chemotherapy have clear stage IV disease, liver involvement, bulky disease in the chest, or disease that is deemed unresectable by imaging, adds Horowitz.