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Experts from The Ohio State University and Allegheny Health Network discuss the exciting research being conducted at their institutions.
At the 2019 OncLive® State of the Science Summit™ on Ovarian Cancer, we asked experts from The Ohio State University and Allegheny Health Network about the exciting research being conducted at their institutions.
David O'Malley, MD
David O’Malley, MD: Professor, Department of Obstetrics and Gynecology, The Ohio State University College of Medicine; Director, Gynecologic Oncology, The Ohio State University Comprehensive Cancer Center (OSUCCC)—James
“At this point, the frontline ovarian cancer trials are absolutely the highest priority. When we’re looking at [novel treatments] in these patients, [we’re] really going for curative intent. Looking at the results of SOLO-1 and germline and somatic BRCA [mutations], we may have as high as half of these patients potentially being cured of their advanced ovarian cancer.
The other very exciting area is antibody-drug conjugates (ADCs). I believe there’s an important opportunity for us to have an assay-based therapy for which we can identify which patients will have the best opportunity for benefit while minimizing toxicity.
[Ongoing] combination trials are also examining PARP and immunotherapy, as well as PARP plus immunotherapy plus anti-VEGF agents. We hope [these trials] will show as great a benefit as we saw with PARP inhibitors in patients with BRCA mutations.”
Ritu Salani, MD
Ritu Salani, MD: Gynecologic Oncologist, Associate Professor, Department of Obstetrics and Gynecology, at The Ohio State University Wexner Medical Center
“My research looks at targeted therapies in [patients with] cervical cancer. It’s interesting because many of these treatments overlap with different disease sites. My particular interest is [examining the use of] PARP inhibitors in cervical cancer, but also other areas that are targeting DNA damage.
One of the challenges with cervical cancer is that when these women have recurrent disease, they often have poor survival and we rarely achieve cure. Unfortunately, these women tend to be on the younger side as well. We have challenges in dealing with therapies that may be toxic. For me, finding regimens that improve survival outcomes and cure rates but also minimize long-term toxicities [is of the upmost importance]. In using targeted therapies [in these patients], I believe we have an opportunity. However, we have to understand a little bit more about cervical cancer.
Among the most exciting [research areas] is immuno-oncology, and I believe cervical cancer is a very logical disease to target. Another intriguing area is using these therapies as maintenance in [patients with] cervical cancer after a chemotherapy induction. [By doing that,] we could ideally provide benefit to these women without causing great toxicity.”
Leigha Senter, MS, LGC
Leigha Senter, MS, LGC: Associate Professor of Clinical, Human Genetics, The Ohio State University Wexner Medical Center
“One of the things that I’m currently looking at is helping families share information about their genetic test results. We know that universally we’re not doing a good enough job when it comes to cascade testing, which is when we test a family for a mutation that was already identified in one of their relatives. In fact, the Centers for Disease Control and Prevention has deemed this a public health problem.
Part of that probably has something to do with the fact that we are putting all of that responsibility on patients to go explain something that’s complicated to their family members, often while they’re dealing with their own disease. Part of my research is studying ways that we can communicate that information to family members. To this end, we’re looking at using different media such as videos, text messages, etc., to make [this information] more digestible for patients and their families.”
Jeffrey Fowler, MD
Jeffrey Fowler, MD: Professor of Gynecologic Oncology, Medical Director, Robotic Surgery Program, The Ohio State University Medical Center
“Although not me specifically, our group participates in many clinical trials. We have a large number of trials [ongoing], most of which are for patients with ovarian cancer. If you look at where we are now with standard therapies, those are the result of many clinical trials that have been done over the past 20 years. We’re quite dedicated to putting patients on clinical trials when appropriate and offering them that extra treatment option. That’s my main focus—taking care of patients with ovarian cancer, doing the surgery they need or not, and getting them onto clinical trials so that we can help them and the next [generation] of patients.”
Larry Copeland, MD
Larry Copeland, MD: Gynecologic Oncologist, The OSUCCC—James
“My current research is through the [Gynecologic Oncology Group [GOG]) Foundation, Inc. I currently serve as the president of the GOG Foundation, Inc., and we do clinical trials with federal funding through the NRG Oncology membership and then we do clinical trials through sponsored funding via our GOG partners. The 2 directors of [that program] are Robert L. Coleman, MD, of The University of Texas MD Anderson Cancer Center, and Bradley J. Monk, MD, FACOG, FACS, of Arizona Oncology, and they do a great job with it. Several others are very active in interfacing with industry, designing trials, conducting advisory boards, and more. I just watch them and admire their intelligence and energy; that’s my role.”
Floor J. Backes, MD
Floor Backes, MD: Assistant Professor, Division of Gynecologic Oncology, Member, Cancer Control Program, OSUCCC¬—James
“We are doing a phase I study here that combines rucaparib (Rubraca) with mirvetuximab soravtansine, a folate receptor alpha—targeting ADC. That is a combination that we believe may be interesting for patients.”
Casey Cosgrove, MD
Casey Cosgrove, MD: Gynecologic Oncologist, OSUCCC—James
“My research mostly focuses on predictive and prognostic biomarkers. One thing that I hate as a gynecologic oncologist is sitting across from a patient whose cancer should not have come back on paper and they look at me and say, “How did this cancer come back?” We’re trying to figure out the building blocks of cancer [to understand] what makes them come back. If I can identify something in a tumor that might put a patient at high risk, even though it might be bland on paper, then we can maybe treat them more aggressively upfront, and hopefully, keep the cancer away.”
Sarah Crafton, MD
Sarah Crafton, MD: Gynecologic Oncologist, Allegheny Health Network
“When I was a fellow, my lab mentor, John Hays, MD, PhD, of OSUCC, and I, [explored] some targeted therapies in [patients with] endometrial cancer that we had been focusing on, specifically in the PI3K/AKT/mTOR pathway. That data led to his phase I trial of MLN0128 and bevacizumab (Avastin) for the treatment of patients with recurrent endometrial cancers. That trial has been closed, and I believe it will be presented in the very near future. It was exciting to see that bench research led to a trial, and that [the combination] seems to have efficacy and tolerability.”