Dr Mujumdar on Key Trials Evaluating Treatments for Ovarian Cancer

Vaidehi Mujumdar, MD, first-year gynecology oncology fellow, Atrium Health Levine Cancer Institute, discusses several key trials that have helped shift 

In 2018, data from the phase 3 SOLO-1 trial (NCT01844986) 

led to the FDA approval of olaparib (Lynparza)

 for the frontline maintenance treatment of patients with treatment-naive, advanced epithelial ovarian, fallopian tube, or primary peritoneal cancer harboring germline and somatic 

 mutations, marking it as the first PARP inhibitor indicated for first-line maintenance therapy in this patient population, Mujumdar begins. Following this, several phase 3 trials, including PRIMA (NCT02655016), PAOLA-1 (NCT02477644), ARIEL3 (NCT01968213), and ATHENA-MONO (NCT03522246), evaluated the use of first-line PARP inhibitors in patients beyond the 

-mutated population and explored combination treatments with bevacizumab (Avastin), she explains.

the 2020 FDA approval of niraparib (Zejula)

 for patients with advanced epithelial ovarian, fallopian tube, or primary peritoneal cancer who are in a complete or partial response to first-line platinum-based chemotherapy, regardless of biomarker status, Mujumdar says. The PAOLA-1 trial resulted in 

 approval of the combination of olaparib and bevacizumab for patients with HRD-positive advanced ovarian cancer, including those who may also present with a 

 mutation, Mujumdar notes. Additionally, in December 2022, 

the FDA restricted the use of rucaparib (Rubraca)

 to the second-line maintenance setting and beyond, specifically for patients with recurrent ovarian cancer harboring 

Furthermore, at the 2023 ESMO Congress, investigators presented data with senaparib (IMP4297) maintenance therapy in patients with advanced ovarian cancer from the phase 3 FLAMES trial (NCT04169997), Mujumdar expands. This PARP inhibitor generated an improvement in progression-free survival compared with placebo in all patients with advanced ovarian cancer who responded to frontline platinum-based chemotherapy (HR, 0.43; 95% CI, 0.32-0.58; 

 < .0001), she elucidates. Although it remains uncertain whether the oncology community will adopt yet another PARP inhibitor, senaparib appears to be a promising agent with activity in the maintenance setting across all patients with ovarian cancer, Mujumdar concludes.

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Vaidehi Mujumdar, MD, discusses several key trials that have helped shift the ovarian cancer treatment paradigm.

Dr Mujumdar on Awareness Initiatives to Address Unmet Needs in Ovarian Cancer

Vaidehi Mujumdar, MD, first-year gynecology oncology fellow, Atrium Health Levine Cancer Institute, discusses how awareness initiatives can help address unmet needs in patients with ovarian cancer 

Awareness initiatives play a critical role in addressing the challenges faced by patients with ovarian cancer, particularly in improving early detection and prevention efforts, Mujumdar begins. Heightened awareness encourages individuals experiencing symptoms of ovarian cancer to seek timely evaluation by a gynecologist, enabling early detection of potential abnormalities that may warrant further investigation, she explains.

Prevention and risk reduction strategies are paramount in combating ovarian cancer, Mujumdar expands. Opportunistic salpingectomy, the surgical removal of fallopian tubes during other abdominal surgeries for patients who have completed childbearing, has emerged as a promising preventive measure, according to Mujumdar. This procedure, routinely performed alongside cesarean sections or cyst removals, aims to reduce the risk of ovarian cancer by eliminating potential sites of cancer origin within the fallopian tubes, she states. Notably, opportunistic salpingectomy facilitates the histological examination of the fimbriae, potentially improving disease outcomes by identifying mutations associated with high-grade serous ovarian cancer, Mujumdar says.

Clinical trials offer further hope for at-risk individuals, Mujumdar emphasizes. The SOROCk study (NCT04251052) is investigating whether preemptive fallopian tube removal followed by subsequent ovarian removal reduces ovarian cancer risk to the same extent as the standard procedure of removing both organs, Mujumdar explains, adding that patient awareness of such trials empowers them to engage with health care providers.

Ovarian cancer has been described akin to a dandelion scattering seeds throughout the abdomen once it spreads, she continues. The interconnectedness of the fallopian tubes with the abdominal cavity underscores the challenge of treating advanced ovarian cancer once it disseminates, according to Mujumdar. Therefore, preventive surgeries targeting the fallopian tubes represent an ideal approach to curtail disease progression, Mujumdar explains.

For patients diagnosed with ovarian cancer, understanding risk factors and recognizing symptoms remain crucial, Mujumdar notes. Equally important is the engagement with survivorship and advocacy groups, which provide invaluable support throughout the treatment journey, Mujumdar concludes.

Vaidehi Mujumdar, MD, discusses how awareness initiatives can help address unmet needs in patients with ovarian cancer on World Ovarian Cancer Day.

Vaidehi Mujumdar, MD

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Dr Mujumdar on Key Trials Evaluating Treatments for Ovarian Cancer

Dr Mujumdar on Awareness Initiatives to Address Unmet Needs in Ovarian Cancer