Heather Dalton, MD, gynecologic oncologist, Arizona Oncology, discusses toxicities in the frontline treatment of patients with ovarian cancer.

Both PARP inhibitors and immunotherapy have been bursting onto the scene in ovarian cancer, most recently in the frontline setting. With the introduction of these new therapies comes class-specific toxicities that are beginning to be understood.

With PARP inhibitors, there are hematologic events and gastrointestinal toxicities. Dalton says that physicians are getting better about adjusting the dosing of PARP inhibitors when these toxicities arise. For checkpoint inhibitors, there are common but sometimes serious immune-related adverse events such as pneumonitis that need to be tended to. As time goes on, Dalton says that these toxicities will be able to be managed more effectively.

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Heather Dalton, MD, gynecologic oncologist, Arizona Oncology, discusses toxicities in the frontline treatment of patients with ovarian cancer.
 

Dr. Dalton on Toxicities in the Frontline Treatment of Ovarian Cancer

Heather Dalton, MD, gynecologic oncologist, Arizona Oncology, discusses the standard of care for patients with ovarian cancer.

Physicians have never quite determined what the standard of care should be for patients with ovarian cancer. Every clinical trial seems to muddy the waters even more, says Dalton. The initial dose-dense regimen showed an improvement in overall survival that rivaled that of intraperitoneal (IP) chemotherapy. Physicians began to embrace the use of dose-dense regimens, but the results of the GOG 252 trial complicated that significantly.

GOG 252 showed no difference in survival between the 2 regimens. This has been attributed to the differences in cisplatin that were given as compared with the ones given in GOG 172 versus the addition of bevacizumab (Avastin). As it stands now, a dose-dense regimen is a good option for a patient with a suboptimally debulked tumor who is not as robust as a younger patient. Fractionated treatments may also be worthy of consideration. IP chemotherapy is a good option for a patient with an optimally debulked tumor and good performance status.

Dr. Dalton on the Standard of Care in Ovarian Cancer

Heather Dalton, MD, gynecologic oncologist, Arizona Oncology, discusses the future of treatment for gynecologic malignancies.

Dalton believes that platinum-based therapy and taxanes will remain the backbone of treatment for this disease. However, with the newest knowledge of 

 and PARP inhibitors, she says, this landscape will hopefully have a stronger maintenance strategy.

Dr. Dalton on the Future Treatment of Gynecologic Malignancies

Heather Dalton, MD, gynecologic oncologist, Arizona Oncology, discusses novel approaches emerging in the field of uterine cancer.

In the uterine cancer field, there have been changes coming over the last few years as researchers are learning more about microsatellite instability (MSI), which is present in select patients with uterine cancers. Additionally, this MSI may be targeted with the use of PD-1 inhibitors, Dalton adds.

Another tumor that is known to be MSI-high includes colorectal cancer, she explains. In the gynecologic field, uterine cancers seem to be the tumor type that have MSI-high characteristics. However, early research suggest that some ovarian cancers may have this, as well.

Heather Dalton, MD

Articles

Dr. Dalton on Toxicities in the Frontline Treatment of Ovarian Cancer

Dr. Dalton on the Standard of Care in Ovarian Cancer

Dr. Dalton on the Future Treatment of Gynecologic Malignancies

Dr. Dalton on Novel Approaches in Uterine Cancer