Breakthrough findings reported in 2018 provide the foundations for paradigm shifts in the care of patients with ovarian cancer. These results have implications for treatment in the first-line setting (with improved and refined use of established treatment modalities), firmly introduce concepts of consolidation and maintenance therapy, and enable more accurate prediction of drug sensitivity and resistance.
Key advances
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Advances in ovarian cancer treatment with interval surgery followed by hyperthermic intraperitoneal chemotherapy and re-definition of the value of secondary surgery pave the way to improve outcomes using established therapies2,3.
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Findings from the SOLO1 trial demonstrated a substantial improvement in progression-free survival in women with BRCA1/2 mutations using maintenance olaparib following initial platinum-based chemotherapy5.
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Translational findings demonstrated the importance of testing tissues before therapy, potentially including identification of copy number variation signatures or BRCA1 methlyation, which might improve the integration of predictive biomarkers for ovarian cancer therapy8,9.
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References
Bommert, M. et al. When should surgery be used for recurrent ovarian carcinoma? Clin. Oncol. 30, 493–497 (2018).
Coleman, R. L. et al. A phase III randomized controlled trial of secondary surgical cytoreduction (SSC) followed by platinum-based combination chemotherapy (PBC), with or without bevacizumab (B) in platinum-sensitive, recurrent ovarian cancer (PSOC): a NRG Oncology/Gynecologic Oncology Group (GOG) study [abstract]. J. Clin. Oncol. 36 (Suppl. 15), 5501 (2018).
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Moore, K. et al. Maintenance olaparib in patients with newly diagnosed advanced ovarian cancer. N. Engl. J. Med. https://doi.org/10.1056/NEJMoa1810858 (2018).
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Macintyre, G. et al. Copy number signatures and mutational processes in ovarian carcinoma. Nat. Genet. 50, 1262–1270 (2018).
Kondrashova, O. et al. Methylation of all BRCA1 copies predicts response to the PARP inhibitor rucaparib in ovarian carcinoma. Nat. Commun. 9, 3970 (2018).
Lin, K. K. et al. BRCA reversion mutations in circulating tumor DNA predict primary and acquired resistance to the PARP inhibitor rucaparib in high-grade ovarian carcinoma. Cancer Discov. https://doi.org/10.1158/2159-8290.CD-18-0715 (2018).
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Oza, A.M. Advances in prediction for ovarian cancer treatment stratification. Nat Rev Clin Oncol 16, 75–76 (2019). https://doi.org/10.1038/s41571-018-0147-3
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DOI: https://doi.org/10.1038/s41571-018-0147-3
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