Selection of Optimal First-Line and Maintenance Therapies in Advanced Ovarian Cancer
Because randomized trial data has shown that many of the options for primary chemotherapy in patients with advanced ovarian cancer have similar outcomes, the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) Ovarian Cancer includes a large list of regimens – including intraperitoneal regimens and regimens containing bevacizumab - as options for neoadjuvant therapy or postoperative adjuvant therapy in patients with newly diagnosed advanced ovarian cancer.3 It is important to note, however, that each of these recommended options is supported by randomized trial data, and there are numerous chemotherapy regimens not included in the list because they were shown to be inferior. For all the recent changes to the NCCN recommendations for primary therapy – including the expansion of the recommendations for neoadjuvant chemotherapy, the addition of HIPEC, and major revisions to the list of postoperative maintenance therapy options - guidance on selection and workup of candidates is critical for safe and appropriate use of the recommended treatments. Deep knowledge of the supporting data, particularly in regards to trial entry criteria and results from sub-analyses, is important for informing treatment selection and optimizing outcomes.
This educational program is designed to meet the educational needs of physicians/oncologists, nurse practitioners, nurses, physician assistants, pharmacists, and other health care professionals who manage patients with cancer.
Following this program, participants should be able to:
- Describe workup for selecting candidates for neoadjuvant therapy and HIPEC, and for determining when to perform interval debulking surgery.
- Compare and contrast patient- and case-specific features when selecting among the recommended chemotherapy regimens for primary treatment.
- Review when to perform BRCA1/2 mutation testing and how to select patients eligible for maintenance olaparib or maintenance bevacizumab.
Heidi J. Gray, MD
Fred Hutchinson Cancer Research Center/ Seattle Cancer Care Alliance
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 no relevant financial relationships:
Heidi J. Gray, MD
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 Perfidio, MS; Shannon Ryan, CMP; Kathy Ann Smith, CHCP; Sarah Weinstein; Gary J. Weyhmuller, MBA, SPHR
The NCCN Activity Planning staff listed below discloses the following relevant financial relationships:
Wui-Jin Koh, MD
IBM Watson Health for Oncology and Genomics; Scientific Advisor
The NCCN Clinical staff listed below discloses no relevant financial relationships:
Jennifer L. Burns, BS; Anita M. Engh, PhD; Rashmi Kumar, PhD
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 1.25 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 1.30 contact hour.
NCCN designates this knowledge-based continuing education activity for 1.25 contact hour (0.125 CEUs) of continuing education credit. UAN: JA4008196-0000-19-058-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 1.25 AAPA Category 1 CME credit. Approval is valid until March 1, 2021. PAs should only claim credit commensurate with the extent of their participation.
- 1.25 AAPA Category 1 CME credit
- 1.25 ACPE contact hours
- 1.25 AMA PRA Category 1 Credit™
- 1.30 ANCC contact hours
- 1.25 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