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Survival & NAC Use Continue to Increase

What your doctor is reading on Medscape.com:

APRIL 02, 2020 — 

Uptake of neoadjuvant chemotherapy (NAC) for the treatment of advanced ovarian cancer has increased dramatically since 2006 in the United States, but importantly, the median survival has also continued to increase, new research shows.

These trends confirm that more widespread use of NAC prior to surgery is not having a negative impact on survival, as some gynecologic oncologists feared, and that the order in which patients receive those treatments does not affect survival for patients with grades IIIC to IV epithelial ovarian cancer, say researchers presenting the new findings.

“Surgery and chemotherapy have been the gold standard for the treatment of newly diagnosed ovarian cancer for many decades with the exception of low-grade, early-stage disease, where you can just do surgery alone,” lead author Anne Knisely, MD, New York–Presbyterian Columbia University Irving Medical Center, in New York City, told Medscape Medical News.

“The important take-away is that survival increased [from 2006 through 2016] irrespective of the accelerated adoption of NAC, so we do not think there is a negative impact from the uptake of NAC in advanced ovarian cancer, although we also don’t see an acceleration in survival either,” she emphasized.

The study was to have been presented at the Society of Gynecologic Oncology’s (SGO’s) 2020 Annual Meeting on Women’s Cancer, in Toronto, Canada. The meeting was canceled because of the COVID-19 pandemic, but abstracts and SGO press releases were issued to allow reporting.

Asked to comment on the findings, Maurie Markman, MD, president of Cancer Treatment Centers of America (CTCA) Medicine and Science, CTCA Health, Philadelphia, Pennsylvania, noted that several previously published well-designed and well-conducted randomized phase 3 trials convincingly demonstrated that NAC does not negatively affect relevant outcomes in advanced ovarian cancer.

“In fact, the opposite is the case,” Markman told Medscape Medical News, “with the studies convincingly revealing reduced postoperative morbidity and mortality.

“Thus, the current study confirms what the trial data clearly revealed, and presumably, the increased survival over time is related to the impact of increasingly effective systemic antineoplastic therapeutics,” Markman observed.


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