Prognostic Factors to Watch Out for in Patients With Ovarian Cancer

Eric Pujade-Lauraine, MD, PhD, head of the Medical Oncology Department at Hôpital Hôtel-Dieu in France, discusses the prognostic factors researchers are looking for when testing patients with ovarian cancer.

According to Pujade-Lauraine, PARP inhibitors can be an effective treatment for patients with ovarian cancer and homologous recombination deficiency (HRD). Results from the phase 3 PAOLA-1 trial (NCT02477644) examining olaparib (Lynparza) added to bevacizumab (Avastin) in adult patients with ovarian cancer in complete or partial response to first-line platinum-based chemotherapy and whose cancer is associated with HRD, led to the approval of olaparib in this patient population.

Within this trial, patients were tested for tumor HRD status using the Myriad myChoice HRD Plus assay, and showed that patients with HRD positivity, regardless of BRCA mutation status, benefited from the combination of olaparib and bevacizumab.

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0:08 | We look for other prognostic factors. One important prognostic factor is the FICO stage, particularly in this advanced stage, the difference between stage 4 and stage 3 disease. Of course, it's more difficult to get a complete resection of all the sites of disease when it is a stage 4.

0:37 | The second most important prognostic factor is the possibility to achieve a complete resection at the upfront surgery. There are different methods to assess this basic capability of the disease when the disease is newly diagnosed. If it is considered, then it will be very difficult to get a complete surgical resection while we propose to the patient a cycle of a chemotherapy and interval debulking surgery, followed by chemotherapy, and then maintenance with a PARP inhibitor. At any point, you have to choose whether or not to add bevacizumab.