Why Some Patients Respond Better to Pre-Surgery Chemotherapy: What This Study Reveals

Predictors of Successful Neoadjuvant Chemotherapy and Interval Cytoreductive Surgery in Management of Ovarian Cancer. **Authors
: Claudia Marchetti, MD, PhD, Gwenael Ferron, MD, et al. JCO Oncology Practice, Nov 24, 2025. DOI: 10.1200/OP-25-00469

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Understanding Neoadjuvant Chemotherapy and Surgery

What the Study Was About

This study focused on individuals with ovarian cancer who receive neoadjuvant chemotherapy (NACT). This means they undergo chemotherapy before surgery. The goal is to achieve a complete interval cytoreductive surgery, which involves removing as much visible tumor as possible during the operation. Researchers aimed to identify which factors—related to patients, tumors, and treatment—are associated with successful NACT. They wanted to know what makes a good response to chemotherapy that allows for full surgical removal.

What “Successful NACT + Surgery” Means in the Study

In this context, “successful” means that after chemotherapy, the tumor responded well enough to permit a complete cytoreductive surgery. This means doctors could remove all or almost all visible cancer during the operation. This treatment plan—chemotherapy first, then surgery—is often used when immediate surgery might be too risky or when the disease appears widespread, making upfront surgery challenging.

Key Findings: Predictors of a Good Response

The study identified specific predictors that increase the likelihood of achieving successful NACT and surgery. Here are some key findings in patient-friendly terms:

• Patients whose tumors responded strongly to chemotherapy—showing shrinkage or favorable changes—had a better chance of effective surgery.

• Certain clinical and tumor characteristics, such as age, overall health status, and the extent or pattern of the disease, were linked to higher odds of success.

  
  

This means not everyone responds the same way to treatment. Doctors can use factors like initial tumor burden, how well chemotherapy is tolerated, and early chemotherapy response to help decide who is a good candidate for NACT and surgery.

Implications for Patients with Abdominal Cancers

For those facing ovarian cancer or similar abdominal malignancies, this study suggests that pre-surgery chemotherapy can be a beneficial first step. It is especially relevant for patients whose tumors are likely to respond well. The findings support a personalized approach to treatment. Instead of a “one-size-fits-all” strategy, treatment plans can be tailored based on individual patient and tumor characteristics that predict better outcomes.

For patient advocacy and awareness, like the work at Abdominal Cancers Alliance, this highlights the importance of early evaluation by specialists. Careful decision-making is crucial in determining whether upfront surgery or NACT followed by surgery is the right first step.

Limitations and Cautions

Even with good predictors, not all patients respond the same way. Chemotherapy before surgery does not guarantee complete surgical removal. Some factors influencing success, such as general health and tumor biology, may not always be modifiable.

Decisions must be individualized. What works for one patient may not work for another. Therefore, it’s essential for patients to discuss their options with experienced specialists in peritoneal or abdominal cancers, as well as gynecologic oncology.

Conclusion

In summary, understanding the predictors of successful NACT and surgery can empower patients and caregivers. It emphasizes the importance of personalized treatment plans and informed decision-making. By focusing on individual characteristics, we can improve outcomes and enhance the quality of life for those facing advanced abdominal cancers.

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