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Personalized Medicine Is the New Frontier in Ovarian Cancer

Saturday, July 20, 2019
As new therapies such as PARP inhibitors have improved survival in patients with ovarian cancer, molecular testing is becoming more important, according to Jubilee Brown, MD.

“Every single patient with ovarian cancer should be tested for germline and somatic mutations at diagnosis without exception,” said Brown, a professor of gynecologic oncology at the Levine Cancer Institute, Atrium Health, in an interview with OncLive®, a sister publication of Oncology Nursing News®.

The benefits of genetic testing for patients and their family members can be two-fold. First, it can guide personalized treatment decisions for people with the disease, while also potentially preventing the disease in others who carry inherited gene mutations.

Brown mentioned promising findings from the SOLO-1 trial, where patients with BRCA-mutant ovarian cancer, who were in complete or partial response to platinum-based chemotherapy treated with olaparib (Lynparza), had a 70% reduction in the risk of disease progression or death compared with those who were given a placebo.

“So much has changed in the field in the last several years. We have the capacity now to test patients with ovarian cancer for both germline and somatic mutations,” Brown said. “When we combine this information, it radically changes how we can treat patients.”

About 7% of patients with ovarian cancer will have germline BRCA-related mutations, and they should all have maintenance therapy with a PARP inhibitor, according to Brown.

Somatic mutations—meaning those that occur within the tumor itself—are not as common as inherited germline mutations and encompass a wider range of genetic mutations. However, it is still important for clinicians to be aware of them.

“Even with rare ovarian cancer, we can find targets,” Brown said. “These are called actionable mutations, meaning we can actually target the tumor with drugs that are more likely to work. This is cutting-edge science and we’re gathering lots of information. Hopefully, in the next few years, we’ll be able to target these specific tumor types with very specific drugs that will work.”

Looking ahead, molecular profiling will continue to change the way that ovarian cancer and other diseases are treated.

“It’s a huge, wide-open field. Over the next several years, we’re going to be able to refine who gets treated with what drug based on very smart technology and molecular profiling,” Brown said. “We’ll be able to decide which drug is best for which patient—not just based on how something looks under the microscope but based on personalized medicine.”

A version of this article originally appeared on OncLive® as, “Molecular Testing Continues to Evolve in Ovarian Cancer.”

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