Dr. Secord on Determining the Management Strategy for Ovarian Cancer

Angeles Alvarez Secord, MD, gynecologic cancers specialist, Duke Cancer Center, discusses determining the management strategy for patients with ovarian cancer.

Both PARP inhibitors and bevacizumab (Avastin) are FDA approved for the treatment of patients with platinum-sensitive ovarian cancer. However, PARP inhibitors and bevacizumab are given is very differently. Bevacizumab is given in combination with chemotherapy and followed with a maintenance strategy. In contrast, the PARP inhibitors are given after a patient has already had platinum-based therapy and demonstrated a response. Regardless, it is up to the physician to determine what management strategy to utilize before the patient begins chemotherapy, says Secord.

It was thought that biomarkers, such as germline BRCA mutations, would help determine the management strategy in a rational manner, explains Second. However, when the NOVA trial was completed it became apparent that there was a benefit across all groups, but the benefits differed based on whether patients had a germline BRCA mutation, homologous recombination deficits, or were germline wild-type.