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...
  • Print
Answer

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.

Did this answer your question?
Additional feedback? (Optional)
Thank you for your feedback!