Dr. Leitao on Eligibility for Neoadjuvant Chemotherapy in Advanced Ovarian Cancer

Mario M. Leitao Jr, MD, FACOG, FACS, fellowship director, gynecology service, director, Minimal Access and Robotic Surgery Program, Department of Surgery, Memorial Sloan Kettering Cancer Center, discusses patient eligibility for neoadjuvant chemotherapy in advanced ovarian cancer.

For patients with newly diagnosed advanced ovarian cancer, primary debulking surgery is still the recommended approach, says Leitao. However, for patients who are ineligible to undergo surgery, neoadjuvant chemotherapy may be an option. Neoadjuvant chemotherapy is typically considered in patients older than the age of 70, those with widespread metastatic disease, and those with a suboptimal performance status or low albumin level, says Leitao. Medical fitness can also help determine if a patient is able to undergo the extensive surgery.

If patients do not meet all 3 of these criteria, a CT scan is ordered to examine the patient’s disease distribution. This can help determine whether or not a complete cytoreduction is possible, and whether neoadjuvant chemotherapy should be given first, says Leitao.