Optimizing ‘optimal’ in ovarian cancer cytoreduction
Keeping a sense of perspective with new cancer therapy is difficult. No more so than when operators who may benefit from change promote new procedures. One such example is the recent TGA approval of the drug Pafolacianine for use in ovarian cancer patients at the time of surgery.
This new drug binds to metastatic deposits of ovarian cancer via folate receptors and is fluorescent when viewed with infrared imaging. Claims from surgeons and the mainstream media suggest this will be a game changer in the management of ovarian cancer. It is suggested that for the first time complete resection of the cancer will be possible at the initial surgery and this will improve outcomes.
This article written by Dr. Rossi cautions against excess enthusiasm, saying that it remains to be seen whether any improvement in survival will result. As she says, “The effect of surgical effort contributes less than that of predetermined patterns of disease presentation”. By which she means that ovarian cancer frequently includes microscopic metastases undetectable by any imaging and that previously, extended surgical resection has proved unhelpful.
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