What are the SGO/ASCO guidelines on neoadjuvant chemotherapy (NACT) for ovarian cancer?

Updated: Aug 10, 2020
  • Author: Andrew E Green, MD; Chief Editor: Yukio Sonoda, MD  more...
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In 2016, the Society of Gynecologic Oncology (SGO) and American Society of Clinical Oncology (ASCO) released guidelines for neoadjuvant chemotherapy (NACT) in newly diagnosed patients with advanced ovarian cancer. The SGO/ASCO guidelines include the following recommendations [44] :

  • NACT should be given to women with a high risk profile or a low likelihood of achieving cytoreduction to < 1 cm
  • Primary cytoreductive surgery is recommended over NACT for women with high likelihood to achieve cytoreduction < 1 cm with good and acceptable morbidity.
  • For women who are fit for primary cytoreductive surgery, with potentially resectable disease, either NACT or primary cytoreductive surgery may be offered.
  • Histologic confirmation (core biopsy preferred) of an invasive ovarian, fallopian tube, or peritoneal cancer should be obtained before NACT is initiated.
  • Platinum/taxane doublet is preferred for NACT; alternate regimens, containing a platinum agent, may be selected based on individual patient factors.
  • Interval cytoreductive surgery should be performed after ≤4 cycles of NACT with a response to chemotherapy or stable disease. 
  • In women with progressive disease on NACT, surgery is indicated only for palliation (eg, relief of a bowel obstruction). Other treatment options include alternative chemotherapy regimens, clinical trials, and/or initiation of end-of-life care.

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