Dr. Sood on Navigating Frontline Maintenance Therapy in Ovarian Cancer

Anil K. Sood, MD, professor, director, Ovarian Cancer Research, co-director, Center for RNA Interference and Non-Coding RNA, vice chairman, Division of Translational Research, director, Blanton-Davis Ovarian Cancer Research Program, co-director, Ovarian Cancer Moonshot Program, Department of Gynecologic Oncology and Reproductive Medicine, Division of Surgery, The University of Texas MD Anderson Cancer Center, discusses navigating frontline maintenance therapy in ovarian cancer.

All patients with high-grade serous or endometrioid ovarian cancer should undergo up-front germline genetic testing to determine whether they harbor BRCA1/2 mutations, Sood says. Data suggest that approximately 15% to 20% of patients will have a germline mutation present; however, the remaining patients should undergo tumor testing to identify somatic BRCA mutations or homologous recombination deficiency (HRD), Sood explains.

Patients with BRCA-mutated or HRD-positive ovarian cancer can be considered for frontline maintenance therapy with a PARP inhibitor, Sood says. In patients without such defects, up-front maintenance therapy with bevacizumab (Avastin) may be considered, or the patient may not receive frontline maintenance at all, Sood concludes.