Alexander B. Olawaiye, MD, director, Gynecologic Oncology Research Program, professor, Gynecologic Oncology, Department of Obstetrics, Gynecology & Reproductive Sciences, Magee-Women’s Hospital, the University of Pittsburgh Medical Center (UPMC) Hillman Cancer Center, discusses how to address disparities in cancer care.

Severe outcome disparities exist for cancer patients in the United States, based on racial and socioeconomical factors, Olawaiye says. If health-care providers and oncologists hope to improve cancer treatment outcomes, optimal care must be provided to all patients under any circumstances, Olawaiye explains.

The first step toward addressing these disparities is to acknowledge their existence, since patients currently receive varying levels of care, and all patients need access to the same care, regardless of race, background, or sociogenic status, Olawaiye continues. Awareness alone will generate a conscious attempt to address these problems moving forward, Olawaiye concludes.

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Alexander B. Olawaiye, MD, discusses how to address disparities in cancer care.


Dr. Olawaiye on How to Address Disparities in Cancer Care

Alexander B. Olawaiye, MD, director, Gynecologic Oncology Research Program, professor, Gynecologic Oncology, Department of Obstetrics, Gynecology & Reproductive Sciences, Magee-Women’s Hospital, the University of Pittsburgh Medical Center (UPMC) Hillman Cancer Center, discusses front line treatment sequencing considerations in ovarian cancer.

The ovarian cancer treatment landscape currently faces the unique problem of having several agents available for treatment in the frontline setting, Olawaiye says. Due to the various treatment choices, it is crucial for clinicians to monitor the latest data when deciding between certain treatments, Olawaiye explains.

Patient costs, including those beyond monetary expenses, need to be factored into treatment decisions for this patient population, Olawaiye continues. Using the data and examining potential toxicities are important steps toward identifying the proper treatment for each patient, Olawiaye concludes.

Alexander B. Olawaiye, MD, discusses front line treatment sequencing considerations in ovarian cancer.

Dr. Olawaiye on Front Line Treatment Sequencing Considerations in Ovarian Cancer

Alexander B. Olawaiye, MD, director, Gynecologic Oncology Research Program, professor, Gynecologic Oncology, Department of Obstetrics, Gynecology & Reproductive Sciences, Magee-Women’s Hospital, the University of Pittsburgh Medical Center (UPMC) Hillman Cancer Center, discusses the social and biological determinants of disparities in women’s cancer.

Institutional racism, conscious and unconscious bias, and lack of patient trust in institutions can all factor into the social determinants of disparities in cancer, Olawaiye says. However, not all disparities can be accounted for by social determinants, Olawaiye adds. For example, when Black women are diagnosed with endometrial cancer, they typically present with higher grade, more dangerous cancer histology types, Olawaiye explains.

Risks are higher for patients who are diagnosed with a more serious form of disease, compared with someone who is diagnosed with a low-grade endometrial cancer, which can be cured by surgery alone, Olawaiye continues. The patients with higher grade cancer are more likely to suffer an early recurrence, and these patients tend to be diagnosed at advanced stages, which is ultimately more likely to kill the patient, Olawaiye says.

While some social determinants impact disparities in cancer, it must also be recognized that biological factors also play a role, Olawaiye says.

Alexander B. Olawaiye, MD, discusses the social and biological determinants of disparities in women’s cancer. 


Dr. Olawaiye on the Social and Biological Determinants of Disparities in Women’s Cancer

Alexander Babatunde Olawaiye, MD, director, Gynecologic Oncology Research Program, assistant professor, Gynecologic Oncology, the University of Pittsburgh and Magee-Womens Hospital, University of Pittsburgh Medical Center (UPMC) Hillman Cancer Center, discusses the investigation of balstilimab plus zalifrelimab in gynecologic cancers.

Currently, the combination is being studied in ongoing clinical trials for patients with gynecologic malignancies and the early data look promising because of the biological mechanism that is being targeted by the agents, Olawaiye says. However, additional data are needed, Olawaiye adds. In the past, clinical trials like the phase 3 JAVELIN OVARIAN 100 (NCT02718417), JAVELIN Ovarian 200 (NCT02580058), and IMagyn050 (NCT03038100) trials that were carefully crafted and conducted evaluated the utility of immunotherapy in gynecologic cancers yielded disappointing outcomes, Olawaiye explains. 

Moreover, clinical rationale suggested that patients may benefit from immunomodulation; however, outcomes of previous studies were examined, they were disappointing, Olawaiye continues. The biological rationale behind the combination of balstilimab and zalifrelimab suggests that more favorable outcomes may be achieved with the combination, Olawaiye concludes.

Alexander Babatunde Olawaiye, MD, discusses the investigation of balstilimab plus zalifrelimab in gynecologic cancers. 


Dr. Olawaiye on Investigating Balstilimab Plus Zalifrelimab in Gynecologic Cancers 

Alexander B. Olawaiye, MD, director, Gynecologic Oncology Research Program, and assistant professor of gynecologic oncology, University of Pittsburgh and Magee-Womens Hospital, University of Pittsburgh Medical Center (UPMC) Hillman Cancer Center, discusses the role of surgery in women with newly diagnosed ovarian cancer.

Typically, women with newly diagnosed ovarian cancer are considered for laparotomy to safely remove as much of the cancer as possible, says Olawaiye.

The goal of laparotomy is to leave patients with no gross residual disease or optimal cytoreductive surgery in which patients are left with <1 cm of residual disease, says Olawaiye.

Though upfront laparotomy may be utilized, physicians are increasingly using laparoscopy to assess the abdomen to determine is the patient is eligible for surgery. Moreover, laparoscopy may identify patients who are not eligible for surgery, sparing patients a large abdominal incision, concludes Olawaiye.

Alexander B. Olawaiye, MD, discusses the role of surgery in women with newly diagnosed ovarian cancer.

Alexander B. Olawaiye, MD

Articles

Dr. Olawaiye on How to Address Disparities in Cancer Care

Dr. Olawaiye on Front Line Treatment Sequencing Considerations in Ovarian Cancer

Dr. Olawaiye on the Social and Biological Determinants of Disparities in Women’s Cancer

Dr. Olawaiye on Investigating Balstilimab Plus Zalifrelimab in Gynecologic Cancers

Dr. Olawaiye on the Role of Surgery in Newly Diagnosed Ovarian Cancer