Dr Chambers on the Role of Genetic Testing and PARP Inhibitors in Ovarian Cancer

Laura J. Chambers, DO, assistant professor, Division of Gynecologic Oncology, The Ohio State University, The Ohio State Comprehensive Cancer Center—James, discusses the role of genetic testing on treatment decisions regarding PARP inhibitor maintenance therapy for patients with ovarian cancer.

Chambers emphasizes that all patients with ovarian cancer should be referred for genetic counseling and undergo both germline and somatic testing at the time of diagnosis. Identifying genetic mutations early in the course of treatment can help oncologists determine the most appropriate maintenance options, which can significantly affect long-term outcomes, Chambers adds.

In addition to genetic testing, Chambers notes the need for early and ongoing discussions between clinicians and patients about maintenance therapy with PARP inhibitors, rather than waiting until the end of chemotherapy. Introducing the concept of maintenance therapy at the time of diagnosis allows patients to mentally prepare for the possibility of continuing treatment beyond initial chemotherapy, which she explains is important since maintenance therapy could last several years. Chambers expresses that setting realistic expectations early on can reduce the likelihood of patients being surprised or overwhelmed by the continuation of therapy.

Additionally, Chambers highlights the importance of having candid conversations with patients about the potential benefits and limitations of maintenance therapy. Although PARP inhibitor maintenance therapy has helped improve outcomes for patients with ovarian cancer, Chambers explains benefit is usually seen after 3 to 4 months of treatment.

Given the frequent blood draws and financial costs associated with PARP maintenance therapy, Chambers advises clinicians to be transparent with patients about the likely outcomes and to discuss the risks and benefits in the context of their specific disease.

By engaging patients in ongoing conversations from the outset of their diagnosis, clinicians can help them navigate the complexities of long-term treatment, setting realistic expectations that can enhance a patient's understanding and preparedness and help optimize treatment adherence and outcomes, ultimately leading to better patient care, Chambers concludes.