Dr Williams on the Evolution of Treatment Approaches in Ovarian Cancer

Heather R. Williams, MD, assistant professor, Department of Obstetrics and Gynecology – Division of Gynecologic Oncology, University of Arkansas for Medical Sciences, discusses the evolution of the ovarian cancer treatment paradigm over the past several decades, as well as the importance of continuing to investigate individualized treatment approaches in this population to expand therapeutic options after disease recurrence.

Patients with ovarian cancer need more therapeutic options, Williams explains. Although most patients with ovarian cancer respond to their first-line therapies, many will eventually experience subsequent disease recurrence, Williams notes. Patients with recurrent ovarian cancer have increasingly limited treatment options, according to Williams. Further research efforts need to focus on the development of additional targeted therapies that are individualized to each patients’ unique disease characteristics, Williams emphasizes. Since all ovarian cancer tumors have different genetic profiles, future investigations should also evaluate which drugs are best for each individual patient, says Williams, who adds that watching these developments unfold is exciting.

Several decades ago, the only available treatment option for patients with ovarian cancer was standard chemotherapy. Although this was an exciting therapeutic development at the time, it pales in comparison with currently available treatment approaches, including antibody-drug conjugates (ADCs) and PARP inhibitors, Williams explains. For instance, the ADC mirvetuximab soravtansine-gynx (Elahere) received accelerated approval from the FDA in 2022 for patients with folate receptor α–positive, platinum-resistant ovarian cancer who have received 1 to 3 prior systemic therapies.

In addition, the PARP inhibitors olaparib (Lynparza) and niraparib (Zejula) are available in select populations. Olaparib is indicated as maintenance therapy for patients with germline BRCA-mutated advanced ovarian cancer who achieved a complete response (CR) or partial response (PR) with first-line platinum-based chemotherapy. Niraparib is indicated as maintenance therapy for patients with advanced ovarian cancer who experienced a CR or PR with first-line platinum-based chemotherapy, as well as in patients with germline BRCA-mutated recurrent ovarian cancer who had a CR or PR with first-line platinum-based chemotherapy. These relatively new agents continue to drive treatment advances for patients with this disease. Additional research with these drug classes, as well as others in development, is highly anticipated, Williams concludes.