New Therapies for Ovarian Cancer
There are a wide range of treatment practices regarding the use of bevacizumab to treat advanced ovarian cancer, and many clinicians may not be aware that NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) Ovarian Cancer are very specific about which bevacizumab-containing regimens are recommended as first-line chemotherapy, neoadjuvant therapy, or treatment for recurrence. The community may also not be aware of the specific subsets of patients in which bevazicumab works best. The context in which maintenance therapy with bevacizumab is recommended in the NCCN Guidelines® for Ovarian Cancer is also very specific, another point that may not be appreciated by practitioners. The NCCN recommended indications for PARP inhibitors are complex. They do not exactly match the FDA-approved indications for these agents, and they vary between agents, so ongoing clinician education on patient selection is needed. Germline and/or somatic BRCA mutations are among the criteria for use of PARP inhibitors (per the NCCN Guidelines) in some but not all treatment settings, and there are multiple new and emerging products for ovarian cancer genetic testing, so there is a need for education on which and when each of these tests are appropriate according to the NCCN Guidelines for Ovarian Cancer.
This information was originally presented at the NCCN 2019 Annual Conference: Improving the Quality, Effectiveness, and Efficiency of Cancer Care™ held in Orlando, Florida, March 21-23, 2019.
This educational program is designed to meet the educational needs of the interprofessional oncology care team, including: physicians/oncologists, nurses, physician assistants, pharmacists, and other healthcare professionals who manage patients with cancer.
Following this program, participants should be able to:
- Describe the specific contexts and regimens in which bevacizumab is recommended in the NCCN Guidelines® for Ovarian Cancer for treatment and maintenance.
- Identify the specific PARP inhibitors recommended in the NCCN Guidelines for treatment of recurrent ovarian cancer, and describe patient selection criteria for each agent.
- Review criteria for considering PARP inhibitor maintenance therapy, as per the NCCN Guidelines® for Ovarian Cancer.
David M. O'Malley, MD
The Ohio State University Comprehensive Cancer Center-James Cancer Hospital and Solove Research Institute
NCCN Medical Education Disclosure Policy
It is the policy of NCCN that every 12 months, all faculty, moderators, activity planners and all internal planning staff participating in NCCN continuing education activities are expected to disclose any financial relationships with a commercial interest as defined by the Accreditation Council for Continuing Medical Education (ACCME) Standards for Commercial Support. In addition, all faculty presentations have been reviewed for adherence to the ACCME’s Standards for Commercial Support (the provider develops activities/educational interventions independent of commercial interests [SCS 1, 2 and 6] by experts on the topics).
Per the ACCME Standards for Commercial Support, individuals who do not disclose relevant financial relationships will be disqualified from involvement in the CE activity as a content developer, planner, or presenter. A complete list of individuals’ relationships with external entities is available upon request.
NCCN continuing education considers financial relationships to create a “conflict of interest” when an individual has both a financial relationship with a commercial interest and the opportunity to affect CE content about the products or services of a commercial interest with which he/she and/or a spouse or partner has a financial relationship.
NCCN continuing education considers “relevant financial relationships” as financial relationships in any amount occurring within the past 12 months that create a conflict of interest. NCCN does not set a minimal dollar amount for relationships to be significant. Inherent in any amount is the incentive to maintain or increase the value of the relationship.
All faculty for this continuing education activity are competent in the subject matter and qualified by experience, training, and/or preparation for the tasks and methods of delivery.
Faculty presentations may include discussion of off-label use. Faculty will disclose that the use in question is not currently approved by the FDA per the product labeling.
The faculty listed below discloses the following relevant financial relationships:
David M. O'Malley, MD
AbbVie, Inc.: Consulting Fee; Grant/Research Support
Agenus Inc.: Grant/Research Support; Scientific Advisor
Ajinomoto Co, Inc: Grant/Research Support
Ambry Genetics: Consulting Fee
Array BioPharma Inc.: Grant/Research Support
AstraZeneca Pharmaceuticals LP: Consulting Fee; Grant/Research Support; Scientific Advisor
Clovis Oncology: Honoraria; Grant/Research Support; Scientific Advisor
ERGOMED Clinical Research Ltd: Grant/Research Support
Exelixis Inc.: Grant/Research Support
Genentech, Inc.: Honoraria; Grant/Research Support; Scientific Advisor
GlaxoSmithKline: Grant/Research Support
ImmunoGen, Inc.: Grant/Research Support; Scientific Advisor
INC Research, Inc: Grant/Research Support
Janssen Pharmaceutica Products, LP: Grant/Research Support; Scientific Advisor
Marker Therapeutics, Inc. (previously TapImmune Inc.): Scientific Advisor
Myriad Genetic Laboratories, Inc.: Scientific Advisor
Novartis Pharmaceuticals Corporation: Grant/Research Support
Novocure: Grant/Research Support; Scientific Advisor
OncoQuest Inc.: Scientific Advisor
Regeneron Pharmaceuticals, Inc.: Grant/Research Support; Scientific Advisor
TESARO, Inc.: Consulting Fee; Grant/Research Support
TRACON Pharmaceuticals, Inc.: Grant/Research Support
NCCN Staff Disclosures
The NCCN Activity Planning staff listed below discloses no relevant financial relationships:
Robert W. Carlson, MD; Melissa Esplen; Mark A. Geisler; Kristina M. Gregory, RN, MSN, OCN; Kristin Kline Hasson; Rose Joyce; Karen Kanefield; Lisa G. Kimbro, MBA, CPA (Employed by NCCN until 8/10/18); Wui-Jin Koh, MD; Joan S. McClure, MS (Employed by NCCN until 8/1/18); Lisa Perfidio, MS; Sarah Sinclair; Kathy Ann Smith, CHCP; Gary J. Weyhmuller, MBA, SPHR
The NCCN Clinical staff listed below discloses no relevant financial relationships:
Anita M. Engh, PhD; Jennifer L. Burns, BS
In support of improving patient care, National Comprehensive Cancer Network (NCCN) is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
NCCN designates this enduring material for a maximum of 0.50 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
NCCN designates this educational activity for a maximum of 0.53 contact hour.
NCCN designates this knowledge-based continuing education activity for 0.50 contact hour (0.050 CEUs) of continuing education credit. UAN: JA4008196-0000-19-052-H01-P
NCCN has been authorized by the American Academy of PAs (AAPA) to award AAPA Category 1 CME credit for activities planned in accordance with AAPA CME Criteria. This activity is designated for 0.50 AAPA Category 1 CME credit. Approval is valid until March 1, 2020. PAs should only claim credit commensurate with the extent of their participation.
- 0.50 AAPA Category 1 CME credit
- 0.50 ACPE contact hours
- 0.50 AMA PRA Category 1 Credit™
- 0.53 ANCC contact hours
- 0.53 Participation
To complete this activity, users will need:
- A device with an Internet connection
- One of the two latest versions of Google Chrome, Mozilla Firefox, or Safari (Internet Explorer is no longer supported)
- Adobe Flash Player and/or an HTML5 capable browser for video or audio playback
- Adobe Reader or other PDF reader software for certificate viewing/printing