Microscopic residual carcinoma at interval debulking surgery after neoadjuvant chemotherapy in patients with IIIc/IV Müllerian carcinoma.

2014 ◽  
Vol 32 (15_suppl) ◽  
pp. 5567-5567
Author(s):  
Kyoko Nishikimi ◽  
Shinichi Tate ◽  
Kazuyoshi Kato ◽  
Takako Kiyokawa ◽  
Makio Shozu
Keyword(s):  
Neoadjuvant Chemotherapy ◽  
Debulking Surgery ◽  
Interval Debulking Surgery ◽  
Residual Carcinoma ◽  
Müllerian Carcinoma

scholarly journals The Added Value of CA125 Normalization Before Interval Debulking Surgery to the Chemotherapy Response Score for the Prognostication of Ovarian Cancer Patients Receiving Neoadjuvant Chemotherapy for Advanced Disease

2020 ◽  
Author(s):  
Wei-feng Liang ◽  
Li-juan Wang ◽  
Jie-ying Wu ◽  
Chang-hao Liu ◽  
Miao-fang Wu ◽  
...  
Keyword(s):  
Neoadjuvant Chemotherapy ◽  
Cox Regression ◽  
Risk Group ◽  
Serous Carcinoma ◽  
Chemotherapy Response ◽  
Debulking Surgery ◽  
Cox Regression Analysis ◽  
Stratification Method ◽  
Interval Debulking Surgery ◽  
Two Factors

Abstract Objective: To investigate whether CA125 normalization following neoadjuvant chemotherapy (NACT) can complement the chemotherapy response system (CRS) in the prognostication of patients with tubo-ovarian high-grade serous carcinoma (HGSC).Methods: In total, 106 HGSC patients who received NACT followed by interval debulking surgery (IDS) for FIGO stage IIIC-IV disease were included, and their clinical data were retrospectively reviewed. The primary endpoint was progression-free survival (PFS). Cox regression analysis was performed to identify predictors of PFS.Results: Following NACT, CRS3 was noted in 24 patients (22.6%), and CA125 normalization (≤ 35 U/ml) was noted in 54 patients (50.9%). Both CRS3 and CA125 normalization were identified as independent prognosticators of PFS. Combining these two factors, we stratified the 106 patients into three groups with different risks of recurrence: low-risk group (CRS3 + post-NACT CA125≤ 35 U/ml; n = 17, 16.0%), intermediate-risk group (CRS3 + post-NACT CA125 > 35 U/ml; n = 7, 6.6%) and high-risk group (CRS1-2; n= 82, 77.4%). The differences in PFS between the three groups were significant (log-rank test, P < 0.0001). In Cox regression analyses, the new stratification method was found to have an independent prognostic effect.Conclusion: Both the CRS system and the normalization of CA125 following NACT could reliably predict the risk of recurrence following primary treatment. The combination of the two factors refined the prognostic stratification of HGSC patients who were treated with NACT and IDS.

Efficacy and safety results from GEICO 1205, a randomized phase II trial of neoadjuvant chemotherapy with or without bevacizumab for advanced epithelial ovarian cancer

2019 ◽  
Vol 29 (6) ◽  
pp. 1050-1056 ◽  
Author(s):  
Yolanda Garcia Garcia ◽  
Ana de Juan Ferré ◽  
Cesar Mendiola ◽  
Maria-Pilar Barretina-Ginesta ◽  
Lydia Gaba Garcia ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Adverse Events ◽  
Response Rate ◽  
Phase Ii Trial ◽  
Debulking Surgery ◽  
Randomized Phase Ii ◽  
Interval Debulking Surgery ◽  
Grade 3 ◽  
Macroscopic Response

BackgroundBevacizumab is an approved treatment after primary debulking surgery for ovarian cancer. However, there is limited information on bevacizumab added to neoadjuvant chemotherapy before interval debulking surgery.ObjectiveTo evaluate neoadjuvant bevacizumab in a randomized phase II trial.MethodsPatients with newly diagnosed stage III/IV high-grade serous/endometrioid ovarian cancer were randomized to receive four cycles of neoadjuvant chemotherapy with or without ≥3 cycles of bevacizumab 15 mg/kg every 3 weeks. After interval debulking surgery, all patients received post-operative chemotherapy (three cycles) and bevacizumab for 15 months. The primary end point was complete macroscopic response rate at interval debulking surgery.ResultsOf 68 patients randomized, 64 completed four neoadjuvant cycles; 22 of 33 (67%) in the chemotherapy-alone arm and 31 of 35 (89%) in the bevacizumab arm (p=0.029) underwent surgery. The complete macroscopic response rate did not differ between treatment arms in either the intention-to-treat population of 68 patients (6.1% vs 5.7%, respectively; p=0.25) or the 55 patients who underwent surgery (8.3% vs 6.5%; p=1.00). There was no difference in complete cytoreduction rate or progression-free survival between the treatment arms. During neoadjuvant therapy, grade ≥3 adverse events were more common with chemotherapy alone than with bevacizumab (61% vs 29%, respectively; p=0.008). Intestinal (sub)occlusion, fatigue/asthenia, abdominal infection, and thrombocytopenia were less frequent with bevacizumab. The incidence of grade ≥3 adverse events was 9% in the control arm versus 16% in the experimental arm in the month after surgery.ConclusionsAdding three to four pre-operative cycles of bevacizumab to neoadjuvant chemotherapy for unresectable disease did not improve the complete macroscopic response rate or surgical outcome, but improved surgical operability without increasing toxicity. These results support the early integration of bevacizumab in carefully selected high-risk patients requiring neoadjuvant chemotherapy for initially unresectable ovarian cancer.

scholarly journals Predictive value of changes in the serum CA-125 levels in patients undergoing interval debulking surgery after neoadjuvant chemotherapy in advanced epithelial ovarian carcinoma

2019 ◽  
Vol 8 (2) ◽  
pp. 483
Author(s):  
Sonia Batra ◽  
Ruchi Arora ◽  
Kalpana Dave
Keyword(s):  
Neoadjuvant Chemotherapy ◽  
Ovarian Carcinoma ◽  
Predictive Value ◽  
Epithelial Ovarian Carcinoma ◽  
Ca 125 ◽  
Optimal Cytoreduction ◽  
Normal Range ◽  
Debulking Surgery ◽  
Ovarian Cancers ◽  
Interval Debulking Surgery

Background: The objective of this study is to evaluate the predictive value of serum CA-125 changes in the management of patients undergoing neoadjuvant chemotherapy (NACT) followed by interval debulking surgery (IDS) in advanced epithelial ovarian carcinoma (EOC).Methods: A retrospective hospital-based study of patients with advanced epithelial ovarian cancers (stage III and IV) was conducted at Department of Obstetrics and Gynecology in Gujarat Cancer and Research Institute, Ahmedabad, for two years. Total 50 patients were treated with NACT followed by surgical cytoreduction and followed up till August 2010. Response to NACT, optimal cytoreduction rate and overall response rate were analyzed.CA 125 levels before (baseline) and after NACT were analyzed.Results: Out of 50, there were 43 patients (86%) with stage III disease and 7 (14%) with stage IV disease. Maximum 37(74%) patients had CA 125 levels >500 on presentation while none of the patients had baseline CA125 levels in the normal range (<35). Range of baseline CA 125 was 164-5394.All patients were given NACT and after NACT, out of 50 patients, 22(44%) patients had CA 125 values within the normal range (<35) while 23(46%) had values between 35 and 100. Thus, statistically significant difference (Z = 6.154, P<0.0001) was found between CA 125 level before and after NACT. Out of 45 patients with CA 125 <100, 35(77.8%) underwent optimal cytoreduction.Conclusions: Baseline (prechemotherapy) serum CA-125 levels are powerful indicators of the presence and extent of spread of disease while CA-125 level particularly <100U/ml after NACT strongly predicts optimal cytoreduction in advanced epithelial ovarian cancers.

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