The impact of multiple neoadjuvant chemotherapy cycles in patients with advanced epithelial ovarian cancer: A single center experience
Three to four cycles of neoadjuvant chemotherapy prior to interval debulking surgery is a common treatment of ovarian cancer. This study aimed to determine the impact of increasing the number of neoadjuvant chemotherapy cycles on overall survival), progression-free survival, and disease responses in patients diagnosed with epithelial ovarian cancer. Twenty-eight patients who underwent NACT for advanced-stage EOC were enrolled in a retrospective cohort study conducted at Princess Noorah Oncology Center and King Abdulaziz Medical City between 2010 and 2021 and divided into two groups. Patients in the first group received fewer than six cycles of NACT while those the second group were treated with six or more cycles. Differences in the OS, PFS, and NACT responses were compared. The median OS was 22.50 months ([IQR], 35.75 months) among patients in the group who received fewer than six cycles of NACT and 29.5 months (IQR, 28.75 months) for those treated with six cycles or more (P = 0.67). The median PFS was 12 months (IQR, 16) for the group that received fewer than six cycles, and nine months (IQR, 21.5 months) for patients assigned to the group that received six or more cycles (P = 0.88). Six of the patients from the group that received fewer than six cycles of NACT and five of the patients from the group that received six cycles or more achieved a complete response to therapy (P = 0.81). Increasing the number of NACT cycles did not significantly impact OS, PFS, or the overall response to therapy. However, the study's small patient population presents a limitation.