Ovarian Cancer: Current Treatment and Patient Management

The decisions made by patients with ovarian cancer are tough ones. They affect the entire treatment paradigm, have long-lasting ramifications, and should be made through a collaboration between patients and clinicians, according to Bradley J. Monk, MD, of the University of Arizona Cancer Center, Phoenix, Arizona, and Paula J. Anastasia, RN, MS, AOCN®, of Cedars-Sinai Medical Center in Los Angeles, California, who spoke on the topic at JADPRO Live. Dr. Monk and Ms. Anastasia discussed the rationale behind frontline treatment decisions in advanced ovarian cancer, addressed quality-oflife concerns, and emphasized the importance of genetic testing. Patients should be carefully guided through a discussion of these different treatment strategies, according to Ms. Anastasia. Such complex conversations are best accomplished one step at a time, she maintained. Discussions about advanced disease should center upon survival in the context of hope and realistic goals. “There is a high probability of achieving a remission—not a cure—with chemotherapy,” she emphasized. Women with advanced ovarian cancer have a range of options, and no one treatment is right for every patient. For example, each woman’s cancer comprises certain cell types and molecular abnormalities, such as KRAS mutations in mucinous tumors and BRCA1/2 deficiencies in high-grade serous tumors. Treatments must be designed with these and other individual characteristics in mind. Options include surgical resection, neoadjuvant chemotherapy, weekly chemotherapy, intraperitoneal chemotherapy, and in some cases, targeted agents. The choice among them reflects the art of personalized medicine, the speakers agreed.