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Early Detection Remains Key in Updated NCCN Guidelines for Ovarian Cancer
Date:3/16/2009

n ovarian cancer, the NCCN Guidelines Panel felt it was important to provide information on allergic reactions and recommendations on desensitization regimens.

"Most patients experiencing allergic reactions are able to be desensitized allowing for continued chemotherapeutic treatment, which is vital to the management of ovarian cancer," said Dr. Morgan.

Also new to the updated NCCN Guidelines is the addition of new agents for recurrence therapy, most notably pemetrexed (Alimta(R), Eli Lilly and Company) as well as recommendations for therapies based on the timing of recurrence.

"Seventy-five to 80 percent of patients with stage III or IV ovarian cancer will experience recurrence and this recurrence can occur at any time - during treatment, within 6 months of completing treatment, or more than a year after completing treatment," Dr. Morgan noted. "In the updated NCCN Guidelines, we differentiated appropriate therapy for recurrence based upon the time frame on which it occurs."

Additionally, Dr. Morgan referred to a clinical trial suggesting that pemetrexed is active in recurrent ovarian cancer, to support the new recommendation in the updated NCCN Guidelines.

Dr. Morgan described new updates to the Principles of Primary Surgery section in the updated NCCN Guidelines that included the recommendation to consider completion surgery for patients responsive to chemotherapy with initially unresectable residual disease, as well as recommendations relating to special circumstances including minimally-invasive procedures, and fertility sparing procedures.

Dr. Morgan also discussed recent clinical studies conducted abroad that studied the effect of chemotherapy as an up-front therapy in patients with ovarian cancer, and concluded that "in the United States, up-front debulking surgery remains the recommendation for the best overall survival."

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SOURCE National Comprehensive Cancer Network
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