Dr. Nguyen on Treatment Approaches for Patients With Advanced Ovarian Cancer

Trung Nguyen, DO, MBA, clinical assistant professor, Obstetrics and Gynecology, Gynecologic Oncology, Stanford Medicine, discusses treatment approaches for patients with advanced ovarian cancer.

The use of primary debulking surgery or neoadjuvant chemotherapy in patients with advanced ovarian cancer has generated a lot of debate among gynecologic oncologists, explains Nguyen. Several trials have compared these approaches, 2 of which include the EORTC 55971 and CHORUS trials. However, both trials have been criticized for the low rate of optimal debulking. Moreover, survival tends to be a little bit lower than what is reported in the United States, says Nguyen.

Subsequent trials—–JGOG 0602 and SCORPION––acknowledged these issues and adopted their trial designs to address those concerns. However, both trials failed to show the superiority of neoadjuvant chemotherapy. They did however show increasing rates of perioperative complications with primary debulking surgery. More data are needed before physicians can conclusively say which approach is superior, explains Nguyen.