SGO and ASCO release clinical practice guidelines on ovarian cancer treatment

This week the Society of Gynecologic Oncology (SGO) and the American Society of Clinical Oncology (ASCO) issued a joint clinical practice guideline on ovarian cancer treatment. The guideline provides evidence-based recommendations on whether to use neoadjuvant chemotherapy (NACT) or surgery as the initial treatment for women with stage IIIC and IV epithelial ovarian cancers, which account for 70-80 percent of all ovarian cancers.

"This guideline is a big step forward in one of the most contentious areas within gynecologic oncology," said Alexi A. Wright, MD, MPH, co-chair and ASCO's representative on the Expert Panel that developed the guideline. "It provides clear recommendations to help patients and physicians make more evidence-based and informed decisions when women are first diagnosed with ovarian cancer."

Key guideline recommendations:
• All women with suspected stage IIIC or IV invasive epithelial ovarian cancer should be evaluated by a gynecologic oncologist prior to initiation of therapy to determine whether they are candidates for primary cytoreductive surgery (PCS).
• Women who have a high perioperative risk profile or a low likelihood of achieving cytoreduction to less than 1 cm (ideally to no visible disease) should receive NACT.
• Women who are fit for PCS, with potentially resectable disease, may receive either NACT or PCS.
o For women with a high likelihood of achieving cytoreduction to less than 1 cm (ideally to no visible disease disease), PCS is recommended over NACT.
o For women who are fit for PCS but are deemed by a gynecologic oncologist as unlikely to have cytoreduction to less than 1 cm (ideally to no visible disease), NACT is recommended over PCS.

"This guideline represents an important collaboration between the SGO and ASCO," said Mitchell I. Edelson, MD, co-chair and SGO's representative on the Expert Panel that developed the guideline. "These evidence-based recommendations will improve the quality of care provided to women with ovarian cancer."

The guideline, Neoadjuvant Chemotherapy for Newly Diagnosed, Advanced Ovarian Cancer: Society of Gynecologic Oncology and American Society of Clinical Oncology Clinical Practice Guideline, was published Aug. 8 in both Gynecologic Oncology and the Journal of Clinical Oncology.

The guideline recommendations were developed by a multidisciplinary expert panel with expertise in gynecologic oncology and medical oncology. In addition, a patient advocacy representative was included to provide a patient perspective. The expert panel conducted a systematic review of literature published between March 20, 2005, and March 20, 2015.

SGO and ASCO believe that cancer clinical trials are vital to inform medical decisions and improve cancer care and that all patients should have the opportunity to participate.