Future Perspectives and Unmet Needs in the Treatment of Ovarian Cancer


Chad A. Hamilton, MD, offers closing thoughts on the future outlook and unmet needs in the ovarian cancer treatment landscape.

Case: A 49-Year-Old Woman with BRCA-WT Ovarian Cancer

  • A 49-year-old presented to her primary care physician complaining of abdominal bloating and nausea
  • PMH: mild HTN
  • FH: mother died of breast cancer at age 59; cousin on mother’s side died of ovarian cancer at age 65
  • Imaging: CT reveals small-volume ascites, bilateral 8-cm adnexal masses
  • Labs: CA 125, 285 U/mL
  • Surgical intervention: she underwent exploratory laparotomy followed by omentectomy, bilateral salpingo-oophorectomy, and resection of peritoneal nodules; optimal cytoreduction with < 1 cm of residual disease after surgery
  • Diagnosis: stage IIIC HGSC
  • Treatment: She was treated with IV carboplatin and paclitaxel w/ NK1, 5HT3, and dexamethasone CINV prophylaxis
  • TRAEs: She experienced persistent daily nausea with vomiting on day 1 after chemotherapy
  • Follow-up: After completion of chemotherapy, CA 125, 14.2; clinically NED; patient reports continuing daily nausea


Chad A. Hamilton, MD: There’s a lot to be hopeful and excited about in the ovarian cancer space. This month marks 20 years since I started my gynecologic oncology fellowship, and it feels like the progress in the last 10 years has been exponentially greater than my first 10 years in the field. There still are major gaps when we talk about prevention strategies in ovarian cancer, and that’s been a challenging situation. We haven’t talked about it much today, but that’s an area that certainly deserves continued focus. There hasn’t been much progress in prevention beyond identification of high-risk populations, such as our BRCA patients, and offering these previvors, as we sometimes call them, risk-reducing surgeries prior to their cancers developing. As we learn more about the pathogenesis and precursors of ovarian cancer such as preinvasive lesions of the fallopian tube—and actually, much of what we’ve always called ovarian cancer probably started in the fallopian tube—I’m hopeful that we will have better insight into prevention strategies as we learn more about the pathogenesis of this disease.

There’s also intense interest in universal cancer screening based on a combination of circulating biomarkers. We’re far from being there yet with universal cancer screening, but we now have a couple of rigorous studies laying the foundation for future research in this area with hope of developing screening strategies for a number of cancers where there have been none before.

I think where we’ve seen the most progress and where I see the specialty making the most progress in the next few years is with targeted treatments and biomarkers. We are seeing a continued and welcome explosion of research in these areas. Biomarker-driven companion diagnostics driving molecularly targeted treatments will continue to be the future. The progress in the past 5 to 10 years, as I’ve stated, has been really exciting for what we’ve been able to do. That excitement is only equaled by the possibilities of everything coming down the pike or everything that we see on the horizon. I eagerly await trying to digest all the data from the clinical trials that will be reading out in the next few years, and really expect them to move the needle forward and move the specialty forward and be a tremendous benefit to our patients.

Transcript is AI-generated and edited for clarity and readability.

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