Neoadjuvant chemoimmunotherapy for inoperable ovarian cancer

Aim. To assess the results of neoadjuvant chemoimmunotherapy for patients with inoperable ovarian cancer. Methods. The study included 72 patients with stage IIIС-IV ovarian cancer divided into three groups: with neoadjuvant chemotherapy and with neoadjuvant chemoimmunotherapy with intramuscular and intraperitoneal interferon gamma. Direct and immediate results of the treatment were studied and compared to assess the efficacy of treatment. Besides, ploidy determination and cell cycle analysis were performed on the fresh postoperative specimens by DNA flow cytometry. Immune status was evaluated before and after neoadjuvant therapy. Results. After neoadjuvant polychemotherapy, in the group of intramuscular interferon gamma high-volume surgery was performed in 81.8% of patients, in the group of intraperitoneal interferon gamma - in 87.5% (p ≤0.05), and in the control group (without interferon gamma) high-volume surgery was performed in 34.6% of patients. Recurrence rates were found to be 25% in the group of intraperitoneal interferon gamma (р <0.05) vs. 59.09% in the group of intramuscular interferon gamma and 76.9% in the group without interferon gamma. The study revealed a decreased number of aneuploid tumors in the group of intraperitoneal interferon gamma. The analysis of the immune system showed positive dynamics of the immune status in the groups with interferon gamma. Conclusion. Use of interferon gamma in the complex with neoadjuvant chemotherapy improves direct results of the treatment and extends the time to recurrence; intraperitoneal and intramuscular interferon gamma is characterized by similar positive immunological changes in some cellular immunity parameters; the number of aneuploid tumors in patients with chemoimmunotherapy is lower than in the control group indicating better disease prognosis.