Dr Chambers on the Importance of Patient Counseling in Ovarian Cancer

Laura J. Chambers, DO, assistant professor, Division of Gynecologic Oncology, The Ohio State University, The Ohio State Comprehensive Cancer Center—James Cancer Hospital and Solove Research Institute, discusses the importance of treatment counseling for patients with ovarian cancer considering PARP inhibitor therapy.

Patient counseling is an essential part of the decision-making process when considering the use of PARP inhibitors, particularly given the nuanced benefits depending on a patient’s tumor biology, Chambers begins. The most substantial clinical advantage of PARP inhibitors is observed in patients whose tumors exhibit homologous recombination deficiency (HRD) or BRCA mutations, she states. In these patients, PARP inhibitors have shown significant efficacy, often prolonging progression-free survival (PFS). However, patients who are homologous recombination proficient tend to experience more modest benefit—typically in the range of an additional 3 to 4 months of PFS, Chambers details. This limited improvement needs to be weighed carefully against the potential burdens of treatment, she says.

The adverse effects (AEs) associated with PARP inhibitors, which may include fatigue, nausea, anemia, and the need for frequent blood tests, can be significant, particularly for those who may only see marginal benefits, Chambers continues. She adds that the financial cost of ongoing therapy can be a major factor for patients. Accordingly, it’s important to have honest and thorough discussions with patients about where they fall within the spectrum of treatment benefit and the realistic expectations for their outcomes, Chambers states. This includes being upfront about the potential for AEs, especially as the data suggest that PARP inhibitors may offer little to no benefit in later lines, Chambers notes.

Rather than introducing these discussions at the end of chemotherapy, when patients are often overwhelmed, it is important to engage in ongoing conversations throughout their treatment, Chambers emphasizes. By gradually building on these discussions during regular clinic visits, patients have the time and space to process information, understand their treatment options, and make informed decisions. This approach fosters a stronger sense of partnership in care and ensures that patients feel more prepared and supported as they transition into maintenance therapy with PARP inhibitors, Chambers concludes.