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Learnings From Key Clinical Trials in Ovarian Cancer

Opinion
Video

Experts explore the evolving landscape of ovarian cancer treatment, emphasizing the need for targeted therapies and biomarker-driven approaches.

Video content is prompted by the following:

Lessons From Recent Clinical Trials

Key Discussion Points:

  • Biomarker-Driven Treatment Selection
  • Current challenge of selecting from multiple approved therapies with overlapping biomarkers

  • Need for predictive power of biomarkers beyond simple positivity (eg, understanding implications of HER2 2+ vs folate medium expression)

  • Sequencing implications of therapies with overlapping toxicity profiles
  • Treatment Sequencing Considerations
  • Critical importance of first therapy selection in platinum-resistant setting given patient drop-off with subsequent lines

  • Limited understanding of how different biomarkers interact (BRCA, HRD, CCNE1, HER2, folate receptor)

  • Patient-specific factors influencing treatment selection beyond biomarker status
  • Evolution of Clinical Trial Design
  • Moving away from “spray and pray” approaches with all-comers to biomarker-driven selection

  • Learning from past experiences with immunotherapy trials that enrolled thousands without clear biomarker strategy

  • Need for smarter trial designs that enable more precise patient selection

Notable Insights:

  1. “Which one do I start with? Do I start with trastuzumab deruxtecan or do I start with mirvetuximab and bevacizumab?... Right now, we’re guessing.”
  2. “We’ve said forever, ‘We don’t have mutations, and we don’t have anything to target.’ We have a lot of things to target. We just are at the early days of figuring out what it means.”
  3. “3,000-plus patients exposed to 4 different sponsors’ frontline studies of immunotherapy and PARP...can’t do that again...I think we’ve learned that lesson, and we’re going to do better moving forward.”
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