Molecular Testing Should Play a Critical Role in Ovarian Cancer Treatment

According to a story from Targeted Oncology, Dr. Bradley Monk talked about the importance of molecular testing in determining the treatment course for ovarian cancer at the Targeted Oncology Case Based Peer Perspectives event. Molecular testing can help doctors decide about the best therapeutic option based on the tumor’s distinctive genetic and molecular characteristics. Over time, researchers are learning that the genetic traits of a given tumor are just as or even more important than where the tumor is located.

About Ovarian Cancer

Ovarian cancer can appear on or within the ovary. Ovarian cancer rarely causes distinctive symptoms in its early stages, so many patients are often diagnosed with advanced disease. The risk of getting ovarian cancer is connected to how long a woman has ovulated during her life; women who ovulate for longer periods are at greater risk. Late menopause or early puberty are risk factors, as are not having children, fertility medication, certain genetic variants and mutations (such as BRCA mutations), and exposure to talc, herbicides, and pesticides. Some symptoms of ovarian cancer include fatigue, bloating, a feeling of fullness, loss of appetite, indigestion, abdominal swelling, and pelvic pain. Treatment can include chemo, radiation, surgery, hormone therapy, and immunotherapy. There are many different kinds of ovarian cancer. Five year survival rate is 45 percent in the US. To learn more about ovarian cancer, click here.

Case Study

As an example, Dr. Monk presented a case study of a patient whose tumor was homologous recombination deficient (HRD) and BRCA wild type. In this patient, a recommended treatment would be either niraparib (marketed as Zejula) or bevacizumab (marketed as Avastin). Later in the case example, the patient was able to reach complete response after treatment with bevacizumab and chemo; Dr. Monk said that a good follow up would be a PARP inhibitor (like niraparib), which is effective in patients with BRCA alterations.

Combination treatments such as bevacizumab and olaparib are another option, but the risk of adverse effects increases with combinations and other problems, such as cost, also need to be taken into consideration. Finding appropriate coverage can be difficult for cancer patients when making treatment decisions, especially if the physician wants to consider using combinations off-label.

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