SGO acting on ovarian cancer report recommendations

During the Society of Gynecologic Oncology’s 47^th Annual Meeting on Women’s Cancer today, SGO convened a panel of ovarian cancer experts to discuss the recently released report by the National Academy of Medicine (NAM), “Ovarian Cancers: Evolving Paradigms in Research and Care.”

This report is a comprehensive summary of our current understanding of, and recent progress in the challenges posed to women and gynecologic oncologists by ovarian cancer,”

“The document provides a strong argument that ovarian cancer research is on a steep trajectory of success, and now is the time to invest research dollars and effort into maintaining or increasing this momentum.”

said SGO President Robert L. Coleman, MD.

“Outcomes data in the report are a good historical reference, but do not reflect the potential impact from recent advances in the science. New approaches in early detection, prevention, and treatment make patient access to and participation in clinical trials more important than ever.” 

The report addressed the challenge of designing clinical trials with endpoints that are both reflective of the treatment intervention and contextually meaningful. “For example, it is difficult to determine the impact of a single therapeutic strategy on overall survival because women typically will undergo several subsequent therapies,” said Dr. Coleman.

While overall survival is the most accepted tangible endpoint for clinical trials, SGO now advocates for the use of progression-free survival as an alternative when appropriate, and has been working with regulatory agencies to clarify acceptable endpoints. SGO asserted its leadership on this issue with the publication of two papers in the journal Gynecologic Oncology: “Ovarian cancer clinical trial endpoints: Society of Gynecologic Oncology white paper,” in 2013 and “SGO guidance document for clinical trial designs in ovarian cancer: A changing paradigm” in 2014.

These publications led to a workshop convened by the Food and Drug Administration in September 2015 to further explore issues in clinical trial endpoints.

The NAM report called attention to the near unanimous recommendation “that all women diagnosed with ovarian carcinoma receive referral for genetic counseling and testing regardless of their family history,” but noted that rates of referral are low. SGO announced this recommendation in its “Statement on risk assessment for inherited gynecologic cancer predispositions,” published in September 2014 in Gynecologic Oncology.

In July 2015, SGO conducted a Genetics Summit that included gynecologic and medical oncologists, genetic counselors, and representatives of medical institutions and patient advocacy groups. The summit addressed genetics delivery care models, physician education and training, access and barriers to genetic testing. Recommendations from the summit are in development and will be submitted for publication in the coming months.

The NAM report equally emphasized the importance of educating and informing our partners and patients. SGO provided such education opportunities during this week’s annual meeting by featuring the panel discussion on the NAM report and by recognizing with its Presidential Award the abstract presentation, “Mutations in homologous recombination genes and response to treatment in GOG 218: An NRG Oncology study” by Barbara Norquist, MD, of the University of Washington, Seattle.

This study, which examined mutations in DNA repair genes in women with advanced ovarian cancer, found that the disease remained at bay longer in women with the mutations than without, and that women having cancers with these mutations lived longer. The results underscored the message that women with any type of ovarian cancer should have genetic testing. They also found that the mutation status affected how long a woman may live and remain free from disease.

“SGO will continue to play a leadership role by gathering experts within the gynecologic oncology community to assess the current state of knowledge, to recommend strategies to advance our knowledge, and to improve methods of early detection and treatment,” Dr. Coleman said.