Dr. Secord on Using Biomarkers to Guide Treatment Decisions in Ovarian Cancer

Angeles Alvarez Secord, MD, gynecologic cancers specialist, Duke Cancer Center, discusses the use of biomarkers to guide treatment decisions in patients with ovarian cancer.

There are 3 PARP inhibitors approved in the maintenance setting for all-comers—niraparib (Zejula), olaparib (Lynparza), and rucaparib (Rubraca). Physicians can use biomarkers in that setting to predict a patient’s magnitude of benefit from adding a PARP inhibitor, explains Secord. If a patient has a BRCA mutation, physicians can determine whether it is somatic or germline, and the corresponding benefit that patient is going to obtain. Specifically, the length of progression-free survival if they take a certain PARP inhibitor, says Secord. In addition to accounting for time, physicians can account for toxicity.

Patients who have homologous recombination deficiency will not experience the same magnitude of benefit as those with BRCA mutations, explains Secord. However, they will still see a benefit, and physicians can counsel patients in terms of continuing or discontinuing therapy based on that benefit. Lastly, physicians can counsel patients who have in-tact BRCA wild-type disease about the tradeoffs of therapy.