Article Text
Abstract
Introduction/Background Advanced high-grade ovarian cancer (OC) treatment has recently evolved to include novel targeted agents such as PARP-inhibitors (PARPi). ESMO/ESGO guidelines recommend biomarker testing to guide treatment decision-making. Our survey explores current management of advanced OC in the UK.
Methodology This interim descriptive analysis used data collected between March-April 2023 from ongoing structured interviews with UK-based healthcare professionals (HCPs) involved in the secondary care management of advanced OC (OC-NOW).
Results The analysis included survey responses from 50 HCPs who treat patients with OC. Respondents were mainly based in England (84%; 42/50). HRD (100%; 41/41) and BRCA1/2 (98%; 40/41) were routinely tested before planning maintenance treatment. BRCA1/2 (90%; 37/41) were frequently ranked as the most important biomarkers for treatment decision-making. Most respondents (90%; 36/40) reported a turnaround time of 6 weeks for HRD test results. The median proportion (interquartile range [IQR]) of patients with a BRCA mutation (BRCAmut) was 20.0% (15.0–20.0%), while 25.0% (18.8–30.0%) were HRD (test positive) and BRCA wild type (HRD/BRCAwt), 49.0% (35.0–60.0%) were HRp (test negative) and 10.0% (5.0–11.2%) were HRnd (HR test failure/not determined/inconclusive). Inadequate tissue sampling (73%; 30/41) was the main reason for HRnd. Platinum-sensitive patients typically received PARPi maintenance therapy, regardless of HRD status (table 1). At first relapse, most HCPs (68%; 19/28) used the DESKTOP-III criteria to identify optimal candidates for secondary cytoreduction, with up to 30% of platinum-sensitive patients considered as eligible in 85% (23/27) of centres.
Percentage of patients with advanced high-grade ovarian cancer reported to be receiving treatment following complete response or partial response to first-line platinum-based chemotherapy, according to genetic status
Conclusion These results provide an update on the evolving UK biomarker-driven practice in advanced OC. HRD and BRCA1/2 are now routinely assessed with adequate turnaround times to allow appropriate decision-making for the maintenance regimens of advanced OC. Platinum-sensitive patients typically received PARPi maintenance therapy, irrespective of HRD status. Most HCPs used DESKTOP-III criteria to determine secondary debulking candidates at first relapse.
Disclosures Christina Fotopoulou has received honoraria and expenses from AstraZeneca, MSD, GSK, Tesaro, Roche, Ethicon, and Clovis. Rebecca Bowen has received consultancy and advisory board fees from GSK, AstraZeneca, and Clovis. Ranjit Manchanda has received grants/research support from Barts Charity, Yorkshire Cancer Research, GSK, and Rosetrees Trust, and has also received honoraria and consultancy fees from GSK and EGL. Agnieszka Michael has received consultancy and advisory board fees from EUSA Pharma, GSK, and Ipsen and has received research funding and expenses from Merck. Stephen McCormack, Allan Ullmann, and Anthony Wesselbaum are employees of GSK. Joe Eva is an employee of OPEN Health. Rowan Miller has received grants/research support from MSD and GSK and honoraria/consultancy fees from MSD, GSK, AstraZeneca, Ellipses, Shionogi, Clovis Oncology, and GI Innovation, and has participated in company sponsored speaker’s bureau for GSK, AstraZeneca, Clovis, and Roche.