The published studies suggest that for selected women with stage IIIC or IV epithelial ovarian cancer , neoadjuvant chemotherapy and interval cytoreduction are non-inferior to primary cytoreduction and adjuvant chemotherapy with respect to overall and progression-free survival and are associated with less perioperative morbidity and mortality .
PURPOSE To provide guidance to clinicians regarding the use of neoadjuvant chemotherapy and interval cytoreduction among women with stage IIIC or IV epithelial ovarian cancer .
Phase ii/iii study of intraperitoneal chemotherapy after neoadjuvant chemotherapy for ovarian cancer: ncic ctg ov.21.
Three large r and omized clinical trials have shown a survival benefit in women with stage iii epithelial ovarian cancer ( eoc ) who receive intraperitoneal ( IP ) chemotherapy after optimal primary debulking surgery . The most recent Gynecologic Oncology Group study , gog 172 , showed an improvement in median overall survival of approximately 17 months . That result led to a U.S. National Cancer Institute ( nci ) clinical announcement recommending that IP chemotherapy be considered for this group of women with eoc . However , IP chemotherapy is associated with increased toxicity , and rates for completion of treatment are low ( 42 % in gog 172 ) . The optimal IP regimen and duration of treatment has yet to be defined . Women undergoing chemotherapy before optimal debulking surgery were not included in the studies or in the nci clinical announcement . The National Cancer Institute of Canada Clinical Trials Group has developed a protocol for a r and omized phase ii/iii study which will examine whether IP platinum-taxane-based chemotherapy benefits women who have received neoadjuvant chemotherapy before optimal surgical debulking . To address whether the less systemically toxic  carboplatin can be substituted for cisplatin IP , the first phase of the study will have 3 arms : 1 intravenous-only , and 2 IP-containing regimens . At the end of the first stage , and provided that IP therapy is feasible to administer in this patient population , one of the IP regimens , either IP carboplatin or IP cisplatin , will proceed into a phase iii comparison with the intravenous arm . This exciting new study has gathered international support
The published studies suggest that for selected women with stage IIIC or IV epithelial ovarian cancer , neoadjuvant chemotherapy and interval cytoreduction are non-inferior to primary cytoreduction and adjuvant chemotherapy with respect to overall and progression-free survival and are associated with less perioperative morbidity and mortality .
PURPOSE To provide guidance to clinicians regarding the use of neoadjuvant chemotherapy and interval cytoreduction among women with stage IIIC or IV epithelial ovarian cancer .