Ovarian Cancer | Professor Jonathan A Ledermann

Investigator Perspectives on the Current and Future Management of Newly Diagnosed Ovarian Cancer — Part 2: Our most recent one-on-one interview with Professor Ledermann featuring emerging research and cases from his practice: Biology and histopathologic subtypes of ovarian cancer (0:00) Structure of gynecologic oncology clinical practice in the United Kingdom (1:58) Approach to mutation testing for patients with newly diagnosed ovarian cancer (4:06) Primary debulking surgery versus neoadjuvant systemic therapy in the up-front management of advanced ovarian cancer (6:51) Value of neoadjuvant chemotherapy versus up-front debulking surgery followed by adjuvant chemotherapy (10:08) Higher incidence of visceral metastases in patients with ovarian cancer and BRCA1/2 mutations (13:02) Optimal timing of debulking surgery with (neo)adjuvant chemotherapy for newly diagnosed ovarian cancer (15:22) Efficacy and safety of bevacizumab-containing neoadjuvant therapy followed by interval debulking surgery for advanced ovarian cancer; duration of maintenance therapy with bevacizumab (16:42) ICON8: Results of a Phase III trial evaluating response to neoadjuvant weekly dose-dense chemotherapy as first-line therapy for epithelial ovarian cancer (19:18) Influence of performance status and age on the choice of neoadjuvant versus adjuvant chemotherapy (21:07) Activity and ongoing investigation of PARP inhibitors in combination with chemotherapy and/or bevacizumab and as maintenance therapy for patients with newly diagnosed ovarian cancer with and without germline BRCA mutations (23:12) Consideration of bevacizumab as a component of (neo)adjuvant systemic therapy for patients with ovarian cancer (26:41) Choosing between bevacizumab and olaparib after primary debulking surgery; importance of timely BRCA mutation analysis to aid in this decision (29:21) Progression-free survival benefit with bevacizumab in combination with and after chemotherapy for patients with surgically debulked disease (33:15) Incidence of gastrointestinal toxicities with up-front bevacizumab for ovarian cancer (36:28) Approach to discontinuation of maintenance bevacizumab before surgery (38:13) MSI/DNA mismatch repair testing in ovarian cancer (39:28) PARP inhibitor-associated insomnia (40:32) Case: A woman in her late 50s is diagnosed with Stage IV high-grade serous ovarian cancer with a germline BRCA1 mutation (42:05) Counseling patients with ovarian cancer with germline BRCA mutations who did not receive PARP inhibition as a component of initial therapy about potential use of these agents in future treatment (45:51) Impact of BRCA mutation status on patient prognosis and potential responsiveness to platinum-based chemotherapy (48:05) Case: A woman in her early 70s with Stage IV high-grade serous ovarian cancer with a germline BRCA1 mutation receives olaparib on the Phase III SOLO-1 trial (49:21) Case: A woman in her early 60s with suboptimally debulked Stage IV high-grade serous ovarian cancer receives adjuvant chemotherapy/bevacizumab followed by maintenance bevacizumab (53:03) Biologic rationale for and ongoing evaluation of anti-PD-1/PD-L1 antibodies in combination with PARP inhibitors for newly diagnosed ovarian cancer (56:35) Benefits and limitations of commercially available HRD (homologous recombination deficiency) testing platforms (59:37) Select publications