Unmet Needs in the Maintenance Setting in Ovarian Cancer

An expert panel highlights current unmet needs in the maintenance setting for ovarian cancer.


Ritu Salani, MD, MBA: Before we get into some of the exciting data that [have] been presented, I’d love to hear what you think the unmet needs are in this space.

Bhavana Pothuri, MD: The biggest unmet need is improving outcomes in the HRP patient population. In addition to that, we need more therapeutic opportunities in our platinum-resistant ovarian cancer space. Those are the 2 biggest unmet needs.

Matthew A. Powell, MD: We can be excited that our patients are living longer, but we’re not curing that many more patients. So the more we can do up front to get patients to that “cure” word, which we’re hesitant to use in oncology, is vital as we look at new agents being added to up-front therapy. This is the biggest thing we should be pushing for. We shouldn’t be happy with carboplatin-paclitaxel alone.

Shannon N. Westin, MD, MPH, FACOG: I would say contribution of components, [such as] understanding what each of these new agents brings to the table and trying to tease out a more personalized approach [about] who does need, say, the dual or even triplet [therapy], which we’re about to talk about. So that’s one. The other thing is…really understanding who’s at risk, because we’ve all had patients who have been on a PARP inhibitor for 8 years and did great the whole time, never even bumped a bone marrow. Then someone develops it after only 2 months on a PARP inhibitor. So teasing out some of the molecular factors that might be contributing or the genomic factors that might be contributing to the development of these tragic outcomes. Because we know that when a patient develops therapy-related MDS or AML, their likelihood of survival past 1 year is very low. So that’s another unmet need.

Ursula A. Matulonis, MD: I agree with everyone’s comments. I would add [that] there’s some discussion about potential de-escalation of the duration of PARP inhibitor use. That is inappropriate. It’s appropriate to study to de-risk it even further and reduce the risk of AML plus the financial toxicity and the toxicities that patients experience every day. It’s on the HRP line, but [for] patients who have primary platinum-refractory cancer, those patients who are relatively rare…we just don’t have trials for those patients whose cancers grow through platinum as they’re receiving platinum.

Transcript edited for clarity.

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