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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What the study was about

• The study focused on people with ovarian cancer who are given neoadjuvant chemotherapy (NACT) — meaning chemotherapy before attempting surgery — with the goal of achieving a complete interval cytoreductive surgery (i.e. removing as much visible tumor as possible during surgery).

• Researchers wanted to figure out which factors (patient features, tumor features, treatment-related) were associated with successful NACT (i.e. a good enough response that makes a full surgical removal feasible).

What “successful NACT + surgery” means in the study

• “Successful” in this context means that after chemotherapy, the tumor responded well enough to allow a complete cytoreductive surgery — meaning that during surgery, doctors could remove all (or almost all) visible cancer.

• This type of treatment plan — chemo first, then surgery — is often used when immediate surgery might be too risky or the disease seems widespread, making upfront surgery difficult.

  
  

What did the study find — what predicts a good response

The study identified certain “predictors” that made achieving a successful NACT + surgery more likely. Some of the key findings (in patient-friendly terms):

• Patients whose tumors responded strongly to the chemotherapy — i.e., showed shrinkage or favorable changes — had a better chance of effective surgery.

• Certain clinical and tumor characteristics (which may include age, overall health status, extent or pattern of disease, though the paper’s detailed list is more technical) were linked to higher odds of success.

That means: not everyone responds the same — and doctors might be able to use things like initial tumor burden, how well chemo is tolerated, and early chemo response to help decide who is a good candidate for NACT + surgery.

What this means for patients (and those with peritoneal/abdominal cancers)

• For patients with ovarian cancer (or similar abdominal — peritoneal surface — malignancies), this study suggests that pre-surgery chemotherapy can be a good first step — especially for those whose tumors are likely to respond.

• It supports a personalized approach: rather than “one-size-fits-all,” treatment plans might be tailored based on patient and tumor characteristics that predict better outcomes.

• For patient advocacy and awareness (like your work at Abdominal Cancers Alliance), this highlights the importance of early evaluation by specialists and careful decision-making on whether upfront surgery or NACT + surgery is the right first step.

Limitations and Cautions

• Even with good predictors, not all patients respond the same — chemo before surgery does not guarantee a complete surgical removal.

• Some factors that influence success (e.g. general health, tumor biology) may not always be modifiable.

• Decisions must be individualized: what works for one patient may not for another — so it’s essential patients discuss with experienced specialists in peritoneal/abdominal cancers or gynecologic oncology.

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