A Review of the Latest Advancements in Ovarian Cancer Care Featured at ESMO 2022

Abstract

Ovarian cancer is the seventh most commonly diagnosed cancer among females and the most lethal gynaecologic malignancy globally because of its vague presentation, insidious nature, recurrence, and drug resistance. There is a pressing need to improve survival and quality of life in patients with ovarian cancer in the context of rising global incidence, high risk of relapse, and poor prognosis. Presentations at the European Society for Medical Oncology (ESMO) Congress 2022 from 9th–13th September in Paris, France, showed the breadth and depth of research in ovarian cancer, including a first look at the highly anticipated data from Phase III studies on the impact on overall survival (OS) of poly(ADP-ribose) polymerase (PARP) inhibitors as first-line maintenance therapy. Clinically meaningful OS benefit was shown with olaparib at 5 years’ follow-up in PAOLA-1 and at 7 years’ follow-up in SOLO1. These positive results are a breakthrough in ovarian cancer treatment and are an important indicator that improvements in progression-free survival (PFS) may translate into OS benefits. Studies in which PARP inhibitors showed clinically meaningful efficacy, but OS data remain immature, include PRIMA, in which niraparib as a first-line maintenance therapy maintained clinically significant improvement in progression-free survival at 3.5 years’ follow-up. Research into chemotherapy resistance using a glucocorticoid receptor modulator in combination with nab-paclitaxel as part of second-line treatment showed that glucocorticoid receptor modulation can improve the efficacy of chemotherapy. Pre-clinical and early phase clinical studies are investigating a range of approaches for the treatment of ovarian cancer such as development of a chimeric antigen receptor T cell therapy, combination of a PARP inhibitor and an immune checkpoint inhibitor, and a bispecific antibody. Developments in these areas are awaited with interest. There is considerable focus on biomarkers for prognosis and progression in ovarian cancer, including research on breast related cancer antigen and homologous recombination deficiency testing, cancer antigen 125 (CA125) decline, and circulating tumour DNA (ctDNA); however, wider genetic testing, improved education of physicians on the importance of testing, and increased access to testing are recommended to optimise treatment and disease prevention. The research in ovarian cancer presented at ESMO 2022 marks important progress in this field.

Barriers And Challenges Of Multidisciplinary Teams In Oncology Management: A Scoping Review Protocol

“… 9 17 18 More importantly, the widespread implementation of MDTs in oncology has visible improvement in outcomes such as overall survival, disease-free interval, and lower risk of recurrence. 17 19–21 As MDTs become more prevalent in oncology care, they also bring to light the barriers and challenges that can hinder their effective implementation. Some of these challenges, such as time constraints, communication among MDT participants, patient selection, scope of implementation, and costs, have persisted since the routine implementation of oncology MDTs, 22–25 and many of these publications have also acknowledged the difficulty in resolving these challenges, given the systemic nature of these shortfalls.…”

Safety and management of niraparib monotherapy in ovarian cancer clinical trials

“…Despite an initial positive response, 70–80% of patients will experience disease recurrence within 2 years of completing first-line therapy 1. The introduction of inhibitors of poly (ADP-ribose) polymerase (PARP), a key regulator of DNA damage repair, has significantly enhanced treatment options for advanced epithelial ovarian cancer 1 2. Niraparib is a PARP inhibitor that improved progression-free survival as a maintenance therapy in multiple clinical trials with manageable toxicity,3–6 leading to approval for clinical use 7 8…”

Ivermectin Augments the Anti-Cancer Activity of Pitavastatin in Ovarian Cancer Cells

“…It affects approximately 1 in 70 women and the prognosis for those diagnosed with advanced disease is disappointing, only around 40% of these patients survive for 5 years or more after diagnosis [ 1 ]. Although patients with early-stage disease are usually treated effectively, most patients present with late-stage disease, due to the lack of clear symptoms in the early stages and the lack of an appropriate screening programme [ 2 ]. For these patients with advanced disease, surgery and adjuvant chemotherapy, comprising carboplatin and paclitaxel, are the mainstay of therapy.…”

“…Excitingly, data from the SOLO clinical trial are sufficiently mature to provide data for patients who have received olaparib for a prolonged period. These data show that 67% of patients who received olaparib as a maintenance therapy were alive after 7 years, whereas 47% of patients who received placebo were alive; median overall survival data are not yet available [ 2 ]. Survival data from other PARP inhibitors are eagerly awaited.…”