28 Feb Personalized Medicine: Tailoring Surgical Approach To Ovarian Cancer
Medical Research: What is the background for this study? What are the main findings?
MedicalResearch: What is the background for this approach? What are the main findings?
Dr. Sood: The background involves several different issues: management approaches have varied quite a bit across the US; definition of “optimal” surgery and rates of complete surgical removal of tumor (R0) have also varied. It is quite apparent that patients who benefit the most from surgery upfront are those who have removal of tumor resection. To address these issues, we have implanted a much more personalized approach whereby patients with suspected advanced ovarian cancer undergo laparoscopic assessment using a validated scoring system (based on the pattern and extent of disease noted during laparoscopic assessment); patients with a score <8 undergo upfront debulking surgery and those with a score ≥8 receive neoadjuvant chemotherapy followed by surgery after 3-4 cycles. To date, this program has been fully implemented as part of the Moonshot Program at M.D. Anderson. This program has already resulted in several benefits – for example, prior to this algorithm being put into place among all patients with suspected advanced ovarian cancer, around 20% would have removal of tumor resection; after the implementation of the algorithm, of those going to upfront debulking surgery (after laparoscopic assessment), almost 85% of times removal of tumor resection can be achieved. Also, this method of treatment is allowing for new and innovative clinical trial designs.
Medical Research: What should clinicians and patients take away from your report?
Dr. Sood: The goal of upfront debulking surgery should be complete removal of all macroscopic disease. The algorithm described here allows for a much more personalized approach for treatment of women with ovarian cancer and can be widely implemented.
Medical Research: What recommendations do you have for future research as a result of this study?
Dr. Sood: There are many future opportunities:
1) Role of laparoscopic assessment for treatment of relapsed ovarian cancer;
2) Design and implementation of new clinical trial designs that allow for pre- and post-treatment tissue assessment;
3) Assessment of patient survival based on this personalized treatment approach.
Alpa M. Nick, Robert L. Coleman, Pedro T. Ramirez, Anil K. Sood. A framework for a personalized surgical approach to ovarian cancer. Nature Reviews Clinical Oncology, 2015; DOI: 10.1038/nrclinonc.2015.26
MedicalResearch.com Interview with: Dr. Anil Sood MD (2015). Personalized Medicine: Tailoring Surgical Approach To Ovarian Cancer