Dr Mahner talks to ecancer at ASCO 2025 about data he presented from the international phase III TRUST trial.

This compared primary cytoreductive surgery followed by chemotherapy to neoadjuvant chemotherapy (NACT) followed by interval surgery in non-frail patients with resectable stage IIIB-IVB ovarian cancer. 

In expert surgical centres, primary cytoreductive surgery led to significantly longer progression-free survival (22.2 vs 19.7 months) and numerically improved overall survival (54.3 vs 48.3 months), particularly in stage III patients. 

While overall survival did not reach statistical significance, the trial demonstrated that patients achieving complete resection after primary cytoreductive surgery had the most favourable outcomes. 

These findings support primary cytoreductive surgery as a preferred first-line approach in well-selected patients within high-quality surgical settings.