Melissa M. Hardesty, MD

Melissa M. Hardesty, a gynecologic oncologist at Alaska Women's Cancer Care, discusses the key takeaways of the phase 2 OVARIO study (NCT03326193) examining the combination of a PARP inhibitor and VEGF inhibitor in women with advanced ovarian cancer as well as research still needs to examine in this space.

According to findings of the study presented by Hardestly, this combination as maintenance therapy may be an efficacious strategy for this patient population.

Though the results of the study were favorable, oncologists working in this space still have numerous questions regarding how to optimize treatment for these patients. Experts, including Hardesty, now aim to figure out which agents are best, how to minimize toxicity, and how to ultimately provide their patients with the best outcomes.

 I presented a phase 2 non-randomized trial looking at a combination of a PARP inhibitor and a VEGF inhibitor. While the results are certainly favorable, more needs to be learned about for whom that combination is the most effective. All of the maintenance agents add significant financial toxicity for our patients as well, and I think that it's important for us to use targeted therapy and use them where they're going to be the most effective.

 If you asked me what I would advise for a patient following upfront therapy, a year from now. I may have a different answer. I certainly have a different answer now than I did a year ago. I think that that's going to be a moving target. Medical oncologists must know there's been a huge shift towards a much more aggressive maintenance strategy, among the gynecologic oncology community. We're going to continue to see that, but I think we're going to continue to need to fine tune it, to figure out for who these agents are best, and which agents are the best, and how to minimize the toxicity, both financial and symptomatic of these therapies so that we can have the best outcomes for our patients.

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Melissa M. Hardesty discusses the key takeaways of the phase 2 OVARIO study of a PARP inhibitor plus a VEGF inhibitor in women with advanced ovarian cancer as well as research still needs to examine in this space.


Further Research Needed to Improve Outcomes in Advanced Ovarian Cancer

Melissa M. Hardesty, MD, gynecologic oncologist, Alaska Women’s Cancer Center, discusses the challenges in regard to the treatment landscape for advanced ovarian cancer in the community setting.

Oncologists find that in Alaska in particular, patients must travel far distances in order to receive care. Even with new advancements in gynecologic oncology treatments and the availability of effective PARP inhibitors, this population does not have the same benefits as others since managing the toxicity of treatment in the community setting is also a main challenge.

There is also an ongoing problem regarding maintenance agents as women report more adverse events (AEs) that negatively impact their quality of life after upfront therapy, according to Hardesty. While patients with ovarian cancer are living significantly longer than previously, recurrence of disease can still occur.

 In the community setting, dealing with treatment toxicity is an ongoing issue. With using maintenance agents, women experience more AEs that persist after upfront therapy. It's a matter of balancing, upfront treatment and maintenance treatment, and the AEs that it has on maintaining quality of life.

 We are certainly allowing many women with ovarian cancer to live significantly longer than they have previously. But ultimately, they do end up often suffering recurrences of disease, and when that happens, we want to have them have a good quality of life when they're off therapy or between therapies.

 I think it's always a balance between toxicity and managing the cancer and trying to allow people to have a good quality of life. Also, in my community, specifically in more rural settings, there's certainly a lot of logistics involved in getting women to care. That often presents some barriers as well.

Melissa M. Hardesty, MD, discusses the challenges faced within the community setting in regard to the treatment landscape for advanced ovarian cancer.

Melissa M. Hardesty, MD | Authors

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Further Research Needed to Improve Outcomes in Advanced Ovarian Cancer

Key Challenges With Treating Ovarian Cancer in the Community Setting