Dr. Naumann on Neoadjuvant Chemotherapy in Patients With Ovarian Cancer

R. Wendel Naumann, MD, gynecologic oncologist, Levine Cancer Institute, Carolinas HealthCare System, discusses the use of neoadjuvant chemotherapy in patients with ovarian cancer.

Surgery still remains an important aspect of care for patients with ovarian cancer, says Naumann. The traditional paradigm has been surgery followed by chemotherapy, but emerging evidence suggests that giving neoadjuvant chemotherapy is a rational option for patients. The morbidity from surgery is lessened and there is an improvement in the complete resection rate with this approach, explains Naumann.

However, neoadjuvant chemotherapy has yet to be adopted worldwide because survival has been less than expected. That may be a result of selecting a subset of patients who are likely to do poorly in general, says Naumann. Four randomized trials have shown that neoadjuvant chemotherapy is a viable approach with an equivalent outcome to primary debulking. At Levine Cancer Institute, physicians are now looking at incorporating minimally invasive surgery to further reduce the morbidity and mortality from the primary surgery, says Naumann.