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Gynaecological Cancers, Ovarian Cancer View Time: 62 mins

touchROUNDTABLE Clinical decision making in advanced ovarian and advanced/recurrent endometrial cancers

Watch leading experts Jalid Sehouli, Nicole Concin, Shibani Nicum and Lynn Buckley discuss how to individualise clinical decision making for gynaecological cancers.

Prof. Jalid Sehouli

Charité-Berlin University of Medicine, Berlin, Germany

CHAIR

Panelists:
Prof. Nicole Concin, Prof. Shibani Nicum, Ms Lynn Buckley
 
Open and introductions

Prof. Sehouli introduces the expert panel and provides an overview of the content of the discussions.

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Presentation: Individualising treatment decisions in advanced ovarian cancer

Prof. Nicum provides an overview of the presentation of advanced ovarian cancer and initial decision making, including biomarker testing, treatment selection, the management of adverse events and how to empower patients.

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Panel discussion: Individualising treatment decisions in advanced ovarian cancer.

The panel discusses key issues for individualising advanced ovarian cancer treatment including when to perform biomarker testing, surgical considerations and which patients may benefit from maintenance therapy.

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Key take home messages for advanced ovarian cancer

The panel provide their key take home messages for the individualised treatment of advanced ovarian cancer.

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Presentation: managing individualised treatment in advanced recurrent/endometrial cancer

Prof. Concin provides an overview of advanced endometrial cancer presentation and initial decision making, biomarker-guided treatment selection, and how to manage adverse events and support patients.

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Panel discussion: managing individualised treatment in advanced/recurrent endometrial cancer

The panel discuss key issues for individualising advanced endometrial cancer treatment including when and for which markers should biomarker testing be performed, the key factors in systemic treatment selection, and how to manage adverse events.

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Key take home messages for advanced/recurrent endometrial cancer

The panel provide their key take home messages for the individualised treatment of advanced endometrial cancer.

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Overview & Learning Objectives
Overview

Recent developments in advanced ovarian and advanced/recurrent endometrial cancer including the use of molecular biomarker testing and new treatment options allow for individualised clinical decision making for patients.1–5 In this activity, leading experts discuss when to perform molecular biomarker testing and which biomarkers to use, key factors informing treatment selection, and how to manage adverse events and ensure patients are empowered in the management of their disease.

Learning Objectives

After watching this activity, participants should be better able to:

  • Describe important biomarkers for making individual treatment decisions in advanced ovarian and advanced/recurrent endometrial cancers
  • Explain how treatment decisions can be made on the basis of patient characteristics in advanced ovarian and advanced/recurrent endometrial cancers taking into account biomarker status, patient characteristics and the option of sequencing of therapy
  • Discuss ways to support patients to proactively manage their treatment for advanced ovarian cancer and advanced/recurrent endometrial cancer to enhance compliance
Faculty & Disclosures
Prof. Jalid Sehouli

Charité-Berlin University of Medicine, Berlin, Germany

Prof. Sehouli is a gynaecological oncologist and director of the department of gynaecology in the Charité/ Campus Virchow-Klinikum and Campus Benjamin Franklin. His interests focus on the surgical therapy and systemic treatment of advanced gynaecological malignancies. In addition to being a principal investigator in clinical trials for ovarian cancer, he has published more than 250 articles on gynaecologic oncology.

Disclosures: Institutional research funding from AstraZeneca, Roche, Pfizer; advisory and speaker honoraria from Novocure, AstraZeneca, GSK, Tesaro, Roche, Abbvie and Clovis; travel expenses from AstraZeneca, Roche, Merck, GSK and Tesaro; and peer-reviewed research funding from MSD, Roche, AstraZeneca, GSK

Prof. Nicole Concin

Innsbruck Medical University, Innsbruck, Austria
Kliniken Essen-Mitte, Essen, Germany

Prof. Nicole Concin is Consultant Gynaecological Oncologist at Evang. Kliniken Essen-Mitte, Essen, Germany, and Professor of Experimental Gynaecology at Innsbruck Medical University, Innsbruck, Austria. She is currently the president elect of the European Society of Gynaecological Oncology, coordinator of the FP7 European project GANNET53 (Ganetespib in metastatic, p53-mutant ovarian cancer) and co-chair of the European Network for Gynaecological Oncological Trial (ENGOT) Early Drug Development Network. She has over 100 publications in gynaecological oncology and has been active in the development of guidelines for the management of patients with endometrial carcinoma.

Disclosures: Consulting/Advisory: Seagen, Akesobio, Ensai, GSK, AstraZeneca, Mersana, Seattle Genetics, eTheRNA immunotherapies NV; travel expenses from Roche, Genmab, Amgen; educational fees from MSD, Medscape Oncology, TouchIME.

Prof. Shibani Nicum

University College Hospital, London, UK

Prof. Nicum is a consultant medical oncologist, current chair of the NCRI Gynae subgroup, specialising in ovarian and other gynaecological cancers at University College Hospital, London. Her interests are in BRCA mutated cancers and the development of new therapies for individualised care. She has been chief investigator on several clinical studies including the CRUK OCTOVA, 6MP BRCA, and ICON9 trials.

Disclosures: Institutional research funding from AstraZeneca, Roche, Pfizer and Abbvie; advisory and speaker honoraria from AstraZeneca, GSK, Tesaro, Roche, Abbvie and Clovis; travel expenses from AstraZeneca, Roche, GSK and Tesaro; and peer-reviewed research funding from AstraZeneca

Ms Lynn Buckley

Hull University Teaching Hospitals NHS, Hull, UK

Ms Buckley is an advanced nurse practitioner at Hull University Teaching Hospitals and has over 30 years’ experience working in gynaecology and over 20 years’ experience as a clinical nurse specialist. She leads a team of clinical nurse specialists in supporting women and their families at diagnosis and throughout their cancer pathway and beyond.

Disclosures: Consulting, advisory and speaker honorarium for GSK, AstraZeneca & Clovis.

References
  1. Lisio MA, Fu L, Goyeneche A, et al. High-Grade Serous Ovarian Cancer: Basic Sciences, Clinical and Therapeutic Standpoints. Int J Mol Sci. 2019;20(4):952.
  2. Miller RE, Leary A, Scott CL, et al. ESMO recommendations on predictive biomarker testing for homologous recombination deficiency and PARP inhibitor benefit in ovarian cancer. Ann Oncol. 2020;31(12):1606-1622.
  3. Lheureux S, Gourley C, Vergote I, et al. Epithelial ovarian cancer. Lancet. 2019;393(10177):1240-1253.
  4. Colombo N, Sessa C, du Bois A, et al. ESMO-ESGO consensus conference recommendations on ovarian cancer: pathology and molecular biology, early and advanced stages, borderline tumours and recurrent disease†. Ann Oncol. 2019;30(5):672-705.
  5. Concin N, Matias-Guiu X, Vergote I, et al. ESGO/ESTRO/ESP guidelines for the management of patients with endometrial carcinoma. Int J Gynecol Cancer. 2021;31(1):12-39.
  6. Makar AP, Tropé CG, Tummers P, et al. Advanced Ovarian Cancer: Primary or Interval Debulking? Five Categories of Patients in View of the Results of Randomized Trials and Tumor Biology: Primary Debulking Surgery and Interval Debulking Surgery for Advanced Ovarian Cancer. Oncologist. 2016;21(6):745-54.
  7. Miralpeix E, Mancebo G, Gayete S, et al. Role and impact of multimodal prehabilitation for gynecologic oncology patients in an Enhanced Recovery After Surgery (ERAS) program. Int J Gynecol Cancer. 2019;29(8):1235-1243.
  8. Nelson G, Bakkum-Gamez J, Kalogera E,et al. Guidelines for perioperative care in gynecologic/oncology: Enhanced Recovery After Surgery (ERAS) Society recommendations-2019 update. Int J Gynecol Cancer. 2019;29(4):651-668.
  9. Ledermann JA, Raja FA, Fotopoulou C, et al. Newly diagnosed and relapsed epithelial ovarian carcinoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2013;24(6):vi24-vi32.
  10. Martin AG, Oza AM, Embleton AC, et al. Exploratory outcome analyses according to stage and/or residual disease in the ICON7 trial of carboplatin and paclitaxel with or without bevacizumab for newly diagnosed ovarian cancer. Gynecol Oncol. 2019; 152(1):53–60.
  11. Huang J, Hu W, Sood AK. Prognostic biomarkers in ovarian cancer. Cancer Biomark. 2010-2011; 8(0): 231–251.
  12. Takaya H, Nakai H, Takamatsu S, et al. Homologous recombination deficiency status-based classification of high-grade serous ovarian carcinoma. Sci Rep. 2020;10(1):2757.
  13. LaFargue CJ, Dal Molin GZ, Sood AK, et al. Exploring and comparing adverse events between PARP inhibitors. Lancet Oncol. 2019;20(1):e15-e28.
  14. Perren TJ, Swart AM, Pfisterer J, et al. A phase 3 trial of bevacizumab in ovarian cancer. N Engl J Med. 2011;365(26):2484-2496.
  15. Jørgensen CR, Thomsen TG, Ross L, et al. What Facilitates "Patient Empowerment" in Cancer Patients During Follow-Up: A Qualitative Systematic Review of the Literature. Qual Health Res. 2018;28(2):292-304.
  16. Simacek K, Raja P, Chiauzzi E, et al. What Do Ovarian Cancer Patients Expect From Treatment?: Perspectives From an Online Patient Community. Cancer Nurs. 2017;40(5):E17-E27.
  17. Faria SC, Devine CE, Rao B, et al. Imaging and Staging of Endometrial Cancer. Semin Ultrasound CT MR.M 2019;40(4):287-294.
  18. Constantine GD, Kessler G, Graham S, et al. Increased Incidence of Endometrial Cancer Following the Women's Health Initiative: An Assessment of Risk Factors. J Womens Health (Larchmt). 2019;28(2):237–243.
  19. van den Heerik ASVM, Horeweg N, de Boer SM, et al. Adjuvant therapy for endometrial cancer in the era of molecular classification: radiotherapy, chemoradiation and novel targets for therapy. Int J Gynecol Cancer. 2021;31(4):594-604.
  20. Jemperli. 2021. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2021/761174s000lbl.pdf (accessed December 2021).
  21. Keytruda. 2014. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/125514Orig1s054lbl.pdf (accessed December 2021).
  22. Londoño MC, Reig M; RETOINMUNO Multidisciplinary Group. Multidisciplinary Clinical Approach to Cancer Patients with Immune-Related Adverse Events Induced by Checkpoint Inhibitors. Cancers (Basel). 2020;12(11):3446.
  23. Myers G. Immune-related adverse events of immune checkpoint inhibitors: a brief review. Curr Oncol. 2018;25(5):342-347.
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