Challenges and Prospects of Neoadjuvant Chemotherapy for Gynecologic Malignancies in Resource-Limited Settings

Abstract

Administration of chemotherapeutic agents followed by interval debulking surgery has been reported to be non-inferior to primary debulking surgery (PDS) and adjuvant chemotherapy. The limitation of human and nonhuman facilities for optimal surgical intervention makes Neoadjuvant chemotherapy (NACT) a desirable alternative in resource-limited settings. NACT is gradually becoming an acceptable alternative in centers with limited facilities for comprehensive PDS. Moreover, some recent studies have described NACT as being non-inferior to the gold standard of PDS although it is important to note that strict patient selection remains an important criterion and serves as the hallmark for the success of NACT. This review aimed to explore the essence of NACT for gynecological malignancies, its challenges as well as prospects for resource-limited settings.