Dr DeBernardo on an Ovarian Cancer Patient Case Study

Robert DeBernardo, MD, section head, Department of Obstetrics and Gynecology, Women’s Health Institute, Cleveland Clinic, discusses a case study seen in a patient with ovarian cancer.

DeBernardo begins by saying that he often finds case presentations intriguing because they apply real-life scenarios and incorporate data from clinical studies into practice. The case that was presented at a 2023 OncLive® State of the Science Summit™ on gynecologic cancers was particularly compelling because it highlighted how ovarian cancer treatment approaches have evolved over time, he explains. For instance, the patient featured in the case would be treated differently today than they were in reality, as they received treatment approximately a decade ago, DeBernardo explains.

As this patient had BRCA-positive disease, contemporary treatment protocols would likely include a combination of surgery, chemotherapy, and PARP inhibition, options that weren't available when she was initially diagnosed, he expands. What's fascinating about this case presentation is the diverse array of interventions employed throughout this patient’s treatment, he states. Instead of solely relying on chemotherapy for recurrences, investigators integrated focal radiation therapy, PARP inhibitors, and maintenance bevacizumab (Avastin), DeBernardo notes. As the ovarian cancer field transitions into an era of folate receptor α–targeted drugs, this patient is now benefiting from such therapy, he emphasizes.

Despite experiencing multiple recurrences, this patient’s emphasis on maintaining quality of life has been a guiding principle in her treatment decisions, he explains. It's remarkable how well this patient is living with her disease, enjoying life despite the challenges she's faced, DeBernardo continues. The case also prompts reflection on the evolving ovarian cancer treatment paradigm, especially with the increasing use of PARP inhibitors in the frontline setting, he says. Although the impact of these agents on overall survival may be limited, they still hold value as therapeutic agents, particularly in homologous recombination deficient–positive patients, DeBernardo states. Questions arise about the role of these agents upon disease recurrence and whether they should be viewed more akin to chemotherapy rather than solely as maintenance therapy, DeBernardo says. This perspective underscores the ongoing relevance of PARP inhibitors in the ovarian cancer therapeutic arena, concludes.