Paul Sabbatini, MD, deputy physician-in-chief for clinical research, Memorial Sloan Kettering Cancer Center, discusses the frontline treatment of patients with newly diagnosed ovarian cancer.

Over the last few years, research has looked at several modalities like intraperitoneal (IP) chemotherapy, the addition of antivascular therapy, and changing the dosing schedule of frontline therapy. Sabbatini says that based on several randomized studies, researchers believe there is no significant benefit from IP chemotherapy. There appeared to be a robust advantage to weekly chemotherapy in the Japanese GOG3016 study, but it appeared to be less so in the subsequent GOG262 study, Sabbatini notes.

Moreover, the ICON8 study demonstrated there was no advantage for weekly therapy over 3-week therapy. Sabbatini concludes that physicians can choose either schedule as a backbone for which to explore novel agents like PARP inhibitors and anti—PD-1 drugs.

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Dr. Sabbatini on Frontline Treatment of Newly Diagnosed Ovarian Cancer

Paul Sabbatini, MD, deputy physician-in-chief for clinical research, Memorial Sloan Kettering Cancer Center, discusses promising therapies in newly diagnosed ovarian cancer.

Immunotherapy has the most potential in this space, Sabbatini says, but it is also the treatment strategy that researchers need to better understand. It is possible that patients with ovarian cancer can be made more susceptible to responding to immunotherapy, but this is still ongoing research. The field has to look beyond single-agent checkpoint inhibitors and toward the potential for combination strategies to turn “cold” tumors into “hot” tumors.

In addition, it is known that PARP inhibitors have transformed the way oncologists approach ovarian cancer, but it is still unknown how to extend their reach. Sabbatini says the field should have data pretty soon about where these drugs fit in and who they work in. Currently, niraparib (Zejula), olaparib (Lynparza), and rucaparib (Rubraca) are FDA-approved as maintenance therapy for patients who have achieved a complete or partial response to platinum-based chemotherapy.

Dr. Sabbatini on Promising Therapies in Newly Diagnosed Ovarian Cancer

Paul Sabbatini, MD, deputy physician-in-chief for clinical research, Memorial Sloan Kettering Cancer Center, discusses novel approaches for IP therapy for patients with ovarian cancer.

Dose-dense therapy or every-3-week therapy allows for many additional combinations in the primary setting, explains Sabbatini. Adding PARP inhibitors, maintenance therapy, anti-vascular agents, or other novel compounds are currently being investigated.

According to Sabbatini, it would be difficult to incorporate those into an IP with cisplatin.

Dr. Sabbatini on Novel Approaches With IP Therapy For Ovarian Cancer

Paul Sabbatini, MD, deputy physician-in-chief for clinical research, Memorial Sloan Kettering Cancer Center, discusses the future of dose-dense therapy in ovarian cancer.

Dose-dense therapy or every-3-week therapy can now be used in several additional combinations in the primary therapy setting. A variety of combinations and strategies are being attempted, which can be difficult to do with intraperitoneal (IP) chemotherapy, explains Sabbatini.

IP chemotherapy is traditionally used to treat patients with ovarian cancer and can treat other gynecologic malignancies, except endometrial or cervical cancers, says Sabbatini.

Paul Sabbatini, MD

Articles

Dr. Sabbatini on Frontline Treatment of Newly Diagnosed Ovarian Cancer

Dr. Sabbatini on Promising Therapies in Newly Diagnosed Ovarian Cancer

Dr. Sabbatini on Novel Approaches With IP Therapy For Ovarian Cancer

Dr. Sabbatini on the Future of Dose-Dense Therapy in Ovarian Cancer