Model suggests surgery should precede chemotherapy for select patients with ovarian cancer

Medium-magnification micrograph of low-grade (LMP) mucinous ovarian tumor. H & E dyeing. Micrographs show: simple mucous epithelium (right) and pseudolayered mucous epithelium (left-diagnosis of LMP tumor). The phyllodes epithelium can be seen at the top of the image. Credits: Nephron / Wikipedia. CC BY-SA 3.0

According to a new study, certain patients with advanced ovarian cancer are more likely to be cured by surgically removing the tumor before chemotherapy.

Led by researchers at the NYU Grossman School of Medicine, Perlmutter Cancer Center, and Dana-Farber Cancer Institute, this study uses mathematical tools to help physicians treat available treatments for high-grade serous ovaries. I investigated whether it should be adjusted. cancer (HGSC).

Ovarian cancer is the eighth most common cancer and cancer death in women worldwide, with HGSC accounting for about 70% of malignant ovarian tumors and having the worst prognosis. Patients in this condition usually Surgery And chemical treatmentHowever, there has been long-standing controversy over the best order of treatment.

Published online on June 14th Minutes of the National Academy of Sciences, The new analysis claims: patient Those who can first undergo “complete weight loss” surgery and then add chemotherapy (called primary weight loss surgery or PDS) should give better results than other major treatment options: tumors before surgery. Give the patient several cycles of chemotherapy to shrink (Neoadjuvant chemotherapy Or NACT).

“The question of whether to use PDS or NACT is very controversial, mainly because of the different characteristics of patients in different clinical studies,” said a college graduate who is the lead author of the study. Dr. Shengqing Gu said. He is currently an instructor at the Dana-Farber Cancer Institute at the University of Toronto. “Therefore, we Mathematical model By simulating the clinical course of HGSC, it is possible to compare the treatment results of the same hypothetical patients and see which groups of patients may respond differently to PDS and NACT. “

“Our model is in combination with before Clinical dataSuggests that surgery is most likely to enable long-term survival or even cure for patients who can undergo complete weight loss, “said the co-author of the research co-author, director of the Perlmutter Cancer Center at NYU. Benjamin G. Neel, MD, Ph.D. Says. Langone Health. “Our model also provides insights into optimal early detection and treatment intervals.”

The researchers used clinical data from approximately 300 patients in a previous study of patient response to PDS or NACT from the Princess Margaret Cancer Center in Toronto and the Canadian Cancer Trial Group.

Researchers have found that weight loss gives better results because patients who are adequate for surgery are most likely to get rid of chemotherapy-resistant cancer cells. For patients who are severely ill to perform weight loss surgery, this study suggests that shorter initial chemotherapy periods may benefit more than the currently recommended intervals. doing.

Current analysis suggests some questions that future randomized clinical trials should consider, the study authors say. These include how the effect of the time lag between surgery and subsequent chemotherapy affects treatment outcomes, whether there is a link between the number of initial chemotherapy cycles and outcomes, and complete secondary to recurrent tumors. This includes whether surgery improves the prognosis.

“Our model shows that some patients can survive or even be cured for a long time, but only if they have undergone complete weight loss and are followed by currently available treatments,” Neil said. I will. “There is an urgent need for new treatments to provide treatments for patients who do not have complete weight loss as an option or who have the most refractory cancer cells.”

New VTEs often occur during chemotherapy for ovarian cancer

For more information:
Shengqing Gu et al. “Computational modeling of ovarian cancer dynamics suggests optimal strategies for treatment and screening.” PNAS (2021).

Provided by
NYU Langone Health

Quote: The model is ovarian cancer obtained on June 14, 2021 from https: // (2021, June 14, 2021) ) Suggests that surgery should be performed prior to chemotherapy for selected patients

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Model suggests surgery should precede chemotherapy for select patients with ovarian cancer Source link Model suggests surgery should precede chemotherapy for select patients with ovarian cancer

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