Follow-up with CA125 after primary therapy of advanced ovarian cancer has major implications for treatment outcome and trial performances and should not be routinely performed

In cases of ovarian carcinoma, primary cytoreductive surgery (CRS) is the standard treatment up to stage IIIB, but patient selection for neoadjuvant chemotherapy (NACT) in selected cases is controversial. A total of 200 patients with advanced ovarian cancer were analyzed retrospectively, according to specific selection criteria. Primary CRS was performed in 95 patients (47.5%) and interval CRS after 3–6 cycles of NACT was performed in 105 patients (52.5%). After median follow-up of 35 months, 5-year overall survival was 53.7% in the upfront CRS group and 42.2% in the NACT group. Primary CRS is the standard in advanced stages of ovarian carcinoma, but in certain subset of patients, NACT is preferred. Identifying that group is challenging but feasible. Proper selection of patients is key to successful outcomes.

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Pervaginal cul-de-sac cytology and CT in the follow-up care of patients with advanced ovarian cancer

Gynecologic Oncology ◽

10.1016/0090-8258(86)90068-5 ◽

1986 ◽

Vol 25 (1) ◽

pp. 84-88 ◽

Cited By ~ 2

Author(s):

Pekka Venesmaa ◽

Ervo Vesterinen ◽

Leena Kivisaari ◽

Usko Nieminen

Keyword(s):

Ovarian Cancer ◽

Advanced Ovarian Cancer ◽

Follow Up Care

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PRIMARY THERAPY OF ADVANCED OVARIAN CANCER

Clinical Obstetrics & Gynecology ◽

10.1097/00003081-196806000-00003 ◽

1968 ◽

Vol 11 (2) ◽

pp. 388

Author(s):

&NA;

Keyword(s):

Ovarian Cancer ◽

Advanced Ovarian Cancer ◽

Primary Therapy

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Efficacy of dose-dense chemotherapy as first-line treatment of advanced ovarian cancer patients after non-optimal debulking.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.15_suppl.e18066 ◽

2020 ◽

Vol 38 (15_suppl) ◽

pp. e18066-e18066

Author(s):

Alexey Rumyantsev ◽

Alexandra Tyulyandina ◽

Ilya Pokataev ◽

Konstantin Morkhov ◽

Valentina Mikhailovna Nechuskina ◽

...

Keyword(s):

Ovarian Cancer ◽

Cancer Patients ◽

Advanced Ovarian Cancer ◽

Residual Tumor ◽

Severe Neutropenia ◽

Front Line ◽

Debulking Surgery ◽

Dose Dense ◽

Optimal Debulking

e18066 Background: Patients with advanced ovarian cancer have unfavorable prognosis after primary debulking surgery if the size of residual tumor exceeds 1 cm. The optimal approaches to systemic treatment of these patients remain unknown. We evaluated the efficacy and safety of dose-dose chemotherapy in frontline treatment of ovarian cancer patients after upfront non-optimal debulking surgery. Methods: This was a non-randomized single-arm phase II trial. We enrolled patients with advanced (FIGO III-IV) epithelial ovarian who underwent non-optimal upfront debulking surgery with residual tumor size > 10 mm. All patients were treated with dose-dense chemotherapy (ie, paclitaxel 80 mg/m2 day 1, 8, 15 + carboplatin AUC6 day 1, cycled every 21 days – 6 cycles). Patients in historical control arm received standard chemotherapy with paclitaxel 175 mg/m2 day 1 + carboplatin AUC6 day 1, cycled every 21 days – 6 cycles. No patient in experimental or control arm received front-line bevacizumab or PARP inhibitors. The primary endpoint of the trial was progression-free survival (PFS). According to the historical data of our department, 1-year PFS in this category of patients equals to 51%. To increase 1-year PFS to 70%, 40 patients should be enrolled with α = 0.05 and β = 0.20 and estimated data loss for 10% of patients. Results: The study enrolled 40 patients to dose-dense chemotherapy arm, control arm included 86 patients. The trial arms were balanced in terms of age, performance status and other characteristics. Median follow-up was 28.8 months. The 1-year PFS was 76.9% compared to 51% in historical arm, median PFS was 19.8 months and 12 months respectively (HR 0.61; 95% CI 0.39-0.95; p = 0,03). The 1-year overall survival rate was 92.3% with median OS not reached with specified follow-up period. Severe neutropenia, anemia, thrombocytopenia was observed in 82.1%, 53.8%, 15.3% of patients, respectively. Conclusions: The results of the study showed high efficacy of dose-dose chemotherapy as front line of treatment for advanced ovarian cancer patients after non-optimal upfront debulking surgery but one should consider high toxicity of this regimen.

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Maintenance olaparib for patients with newly diagnosed, advanced ovarian cancer and a BRCA mutation: 5-year follow-up from SOLO1

Gynecologic Oncology ◽

10.1016/s0090-8258(21)00694-6 ◽

2021 ◽

Vol 162 ◽

pp. S25-S26

Author(s):

William Bradley ◽

Kathleen Moore ◽

Nicoletta Colombo ◽

Giovanni Scambia ◽

Byoung-Gie Kim ◽

...

Keyword(s):

Ovarian Cancer ◽

Brca Mutation ◽

Advanced Ovarian Cancer ◽

Newly Diagnosed

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Preservation of pregnancy in a patient with advanced ovarian cancer at 20 weeks of gestation: case report and literature review

International Journal of Gynecological Cancer ◽

10.1111/j.1525-1438.2007.00917.x ◽

2007 ◽

Vol 17 (5) ◽

pp. 1140-1143 ◽

Cited By ~ 34

Author(s):

M Modares Gilani ◽

M Karimi Zarchi ◽

N. Behtash ◽

F. Ghaemmaghami ◽

A. S. Mousavi ◽

...

Keyword(s):

Ovarian Cancer ◽

Combination Chemotherapy ◽

Advanced Ovarian Cancer ◽

Figo Stage ◽

Serous Carcinoma ◽

Healthy Baby ◽

Resistant Disease ◽

Papillary Serous Carcinoma ◽

Initial Combination

To report a case of FIGO stage III papillary serous carcinoma of ovary, diagnosed during pregnancy at 20 weeks of gestation and treated with unilateral salpingo-oophorectomy and surgical staging, then initial combination chemotherapy while preserving the pregnancy. The patient underwent cesarean section at 35 weeks after four courses of taxol plus carboplatin. She delivered a healthy baby. After that total hysterectomy, omentectomy, pelvic and para-aortic lymphadenectomies were carried out. The surgical resection was complete and no macroscopic residual diseases were seen. During histologic examination, traces of resistant disease were found. The patient underwent three postoperative courses of chemotherapy (carboplatin plus paclitaxel regimen). After 6 months follow-up, the patient remained in complete remission and the child's development was normal. Combination chemotherapy during pregnancy with preservation of the fetus could be considered, and should be discussed with caution in case of epithelial ovarian cancer diagnosed during the second trimester of the pregnancy.

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No correlation between chemotherapy dose and treatment outcome in advanced ovarian cancer

European Journal of Cancer ◽

10.1016/0959-8049(93)91357-q ◽

1993 ◽

Vol 29 ◽

pp. S134

Author(s):

CMPW Mandigers ◽

JJ Keuning ◽

FE van Dam ◽

HAM Broelmann ◽

PFF Wijn

Keyword(s):

Ovarian Cancer ◽

Treatment Outcome ◽

Advanced Ovarian Cancer ◽

Chemotherapy Dose

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Is it possible to improve primary therapy of advanced ovarian cancer?

Medical Council ◽

10.21518/2079-701x-2020-9-128-135 ◽

2020 ◽

pp. 128-135

Author(s):

S. V. Khokhlova

Keyword(s):

Ovarian Cancer ◽

Life Expectancy ◽

Brca1 Mutation ◽

Advanced Ovarian Cancer ◽

Subsequent Treatment ◽

Low Grade ◽

Primary Therapy ◽

Average Life Expectancy ◽

Ovarian Adenocarcinoma ◽

Specific Patient

In 2011, a standard approach to the treatment of primary ovarian cancer (OC) included a cytoreductive surgery, which could be performed after 2–3 cycles of neoadjuvant chemotherapy, and chemotherapy consisting of platinum and taxanes. Such approach was provided for all patients, regardless of tumour histology and any molecular biological and genetic factors. The most complete picture of management and therapy of patients can be made using the treatment of a specific patient as an example. After application to the N.N. Blokhin National Medical Research Center of Oncology in 2011, the patient with OC received standard primary therapy and subsequent treatment of the recurrent disease, which was accompanied by various types of adverse events resulting in the poor quality of life for the patient. The data that some patients with OC have a BRCA1/2 mutation that is significant for prognosis and treatment came to hand later and, unfortunately, the awareness of a significant germinal BRCA1 mutation was of no use to the woman any longer. The life expectancy of this patient was 47 months. This is the average life expectancy for patients with stage IIIC OC. Major changes have been brought in the primary therapy of OC. If a diagnosis of low-grade IIIC ovarian adenocarcinoma was established in this patient today, needless to say that the BRCA1 mutation would be identified during the first-line chemotherapy, and in case of full or partial treatment effect, we would prescribe olaparib as maintenance therapy to the patient. Considering the fact that the median progression-free survival has not yet been achieved in the patients of SOLO-1 study, who received olaparib therapy, and is only approaching 54 months, it can be assumed that even the first relapse could not have developed in this patient.

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