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Second Opinion: New and Emerging Treatment Strategies in the Management of Recurrent Ovarian Cancer
Released January 2018

Featuring perspectives from Dr Ursula A Matulonis. (Video Program)

CE Disclosures and Faculty Information

    This activity is intended for medical oncologists and other healthcare providers involved in the treatment of ovarian cancer (OC).

    The American Cancer Society estimates that in 2017 more than 22,000 new cases of OC were diagnosed in the United States and more than 14,000 individuals died of the disease, making this the most lethal of the various gynecologic cancers. Fewer than 40% of women with OC are ultimately cured, and 70% of patients present with advanced disease, at which point palliation and improvements in quality of life are the primary goals of therapy. As with many other tumors, patient outcomes are critically dependent on effective multidisciplinary care, which in this case often includes contributions from gynecologic, medical and radiation oncologists as well as pathologists, diagnostic radiologists, oncology nurses and psychosocial services. In addition to the disease- and treatment-related morbidity and mortality associated with OC, pain, fatigue, lymphedema, depression/anxiety, infertility/childbearing and sexual dysfunction are commonly occurring issues that must also be addressed in the care of these patients.

    To bridge the gap between research and patient care, this video presentation by Dr Ursula A Matulonis uses a review of recent relevant publications and presentations, ongoing clinical trials and clinical investigator treatment preferences to assist medical oncologists and other healthcare providers involved in the treatment of OC with the formulation of up-to-date clinical management strategies.


    • Evaluate current standard therapies and emerging treatment options, and use this information to appropriately select and sequence therapeutic approaches for patients with recurrent OC.
    • Describe the rationale for targeting angiogenic pathways in gynecologic cancers, and consider the role of the anti-VEGF antibody bevacizumab in the initial and long-term treatment of advanced OC.
    • Use available guidelines and consensus statements to inform the selection of validated genetic testing platforms for patients with OC, and employ the resulting information to guide treatment planning and genetic counseling for these individuals.
    • Understand the rationale for the investigation of PARP inhibitors as monotherapy for patients with BRCA mutation-positive advanced OC, and use this information to inform protocol and nonresearch treatment options for these individuals.
    • Appreciate the FDA approval of rucaparib for patients with refractory advanced OC, and safely integrate this agent into clinical management as appropriate.
    • Evaluate Phase III evidence supporting the use of PARP inhibitor maintenance therapy for patients with recurrent, platinum-sensitive OC with and without BRCA mutations who are responding to platinum-based chemotherapy.
    • Recognize the mechanisms of action, emerging efficacy data and toxicity profiles of investigational agents and immunotherapeutic strategies for the treatment of OC, and counsel appropriately selected patients about the availability of ongoing clinical trials.

    Research To Practice is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

    Research To Practice designates this enduring material for a maximum of 1.25 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

    Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.5 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

    Please note, this program has been specifically designed for the following ABIM specialty: medical oncology.

    Personal information and data sharing: Research To Practice aggregates deidentified user data for program-use analysis, program development, activity planning and site improvement. We may provide aggregate and deidentified data to third parties, including commercial supporters. We do not share or sell personally identifiable information to any unaffiliated third parties or commercial supporters. Please see our privacy policy at ResearchToPractice.com/Privacy-Policy for more information.

    This CME activity consists of a video component. To receive credit, the participant should review the CME information, watch the video, complete the Post-test with a score of 80% or better and fill out the Educational Assessment and Credit Form located at ResearchToPractice.com/GrandRoundsOvarian18/CME.

    Research To Practice (RTP) is committed to providing its participants with high-quality, unbiased and state-of-the-art education. We assess conflicts of interest with faculty, planners and managers of CME activities. Conflicts of interest are identified and resolved through a conflict of interest resolution process. In addition, all activity content is reviewed by both a member of the RTP scientific staff and an external, independent physician reviewer for fair balance, scientific objectivity of studies referenced and patient care recommendations.

    FACULTY — The following faculty (and their spouses/partners) reported relevant conflicts of interest, which have been resolved through a conflict of interest resolution process:

    Presenting Faculty Member

    Ursula A Matulonis, MD
    Medical Director and Program Leader
    Gynecologic Oncology Program
    Professor of Medicine
    Harvard Medical School
    Dana-Farber Cancer Institute
    Boston, Massachusetts

    Advisory Committee: 2X Oncology, Clovis Oncology, Geneos Therapeutics, The Clearity Foundation.

    Project Steering Committee Members

    Michael Birrer, MD, PhD
    Director, UAB Comprehensive Cancer Center
    University of Alabama at Birmingham
    Birmingham, Alabama

    Advisory Committee: Roche Laboratories Inc.

    Robert L Coleman, MD
    Professor and Vice Chair
    Clinical Research
    Ann Rife Cox Chair in Gynecology
    Department of Gynecologic Oncology and Reproductive Medicine
    The University of Texas
    MD Anderson Cancer Center
    Houston, Texas

    Advisory Committee: Abbott Laboratories, AstraZeneca Pharmaceuticals LP, Bayer HealthCare Pharmaceuticals, Clovis Oncology, Genentech BioOncology, Janssen Biotech Inc, Merck, Roche Laboratories Inc; Contracted Research: Abbott Laboratories, AstraZeneca Pharmaceuticals LP, Clovis Oncology, Genentech BioOncology, Janssen Biotech Inc, Merck, Roche Laboratories Inc.

    Don S Dizon, MD
    Director, Women's Cancers
    Lifespan Cancer Institute
    Director, Medical Oncology
    Rhode Island Hospital
    Associate Professor of Medicine
    Alpert Medical School of Brown University
    Providence, Rhode Island

    Consulting Agreement: Fujibio.

    Thomas J Herzog, MD
    Paul and Carolyn Flory Professor
    Deputy Director
    UC Cancer Institute
    Vice Chair, Quality and Safety
    Department of Obstetrics and Gynecology
    University of Cincinnati
    Cincinnati, Ohio

    Advisory Committee: AstraZeneca Pharmaceuticals LP, Clovis Oncology, Johnson & Johnson Pharmaceuticals, Roche Laboratories Inc, Tesaro Inc.

    Bradley J Monk, MD
    Division of Gynecologic Oncology
    Arizona Oncology (US Oncology Network)
    University of Arizona College of Medicine - Phoenix
    Creighton University School of Medicine at St Joseph's Hospital
    Phoenix, Arizona

    Consulting Agreements: Advaxis Inc, Amgen Inc, AstraZeneca Pharmaceuticals LP, Bayer HealthCare Pharmaceuticals, Clovis Oncology, Genentech BioOncology, Gradalis Inc, INSYS Therapeutics Inc, Mateon Therapeutics, Merck, Pfizer Inc, PPD, Precision Oncology, Roche Laboratories Inc, Tesaro Inc; Contracted Research: Amgen Inc, Array BioPharma Inc, Genentech BioOncology, Lilly, Janssen Biotech Inc, Johnson & Johnson Pharmaceuticals, Morphotek Inc, Tesaro Inc; Speakers Bureau: AstraZeneca Pharmaceuticals LP, Genentech BioOncology, Janssen Biotech Inc, Johnson & Johnson Pharmaceuticals, Roche Laboratories Inc.

    Kathleen Moore, MD
    Jim and Christy Everest Endowed Chair in Cancer Research
    Director, Oklahoma TSET Phase I Program
    Stephenson Cancer Center
    Associate Professor
    Section of Gynecologic Oncology
    Director, Gynecologic Oncology Fellowship
    Department of Obstetrics and Gynecology
    University of Oklahoma Health Sciences Center
    Oklahoma City, Oklahoma

    Advisory Committee: AstraZeneca Pharmaceuticals LP, Roche Laboratories Inc.

    Angeles Alvarez Secord, MD, MHSc
    Professor, Department of Obstetrics and Gynecology
    Division of Gynecologic Oncology
    Duke Cancer Institute
    Durham, North Carolina

    Advisory Committee: AstraZeneca Pharmaceuticals LP, Genentech BioOncology, Janssen Biotech Inc, Tesaro Inc; Contracted Research: AbbVie Inc, Amgen Inc, Astellas Pharma Global Development Inc, Astex Pharmaceuticals, AstraZeneca Pharmaceuticals LP, Boehringer Ingelheim Pharmaceuticals Inc, Bristol-Myers Squibb Company, Eisai Inc, Endocyte Inc, Exelixis Inc, Genentech BioOncology, GlaxoSmithKline, Incyte Corporation, Merck, Morphotek Inc, Tesaro Inc.

    PROJECT CHAIR — Dr Love is president and CEO of Research To Practice, which receives funds in the form of educational grants to develop CME activities from the following commercial interests: AbbVie Inc, Acerta Pharma, Adaptive Biotechnologies, Agendia Inc, Agios Pharmaceuticals Inc, Amgen Inc, Ariad Pharmaceuticals Inc, Array BioPharma Inc, Astellas Pharma Global Development Inc, AstraZeneca Pharmaceuticals LP, Baxalta Inc, Bayer HealthCare Pharmaceuticals, Biodesix Inc, bioTheranostics Inc, Boehringer Ingelheim Pharmaceuticals Inc, Boston Biomedical Pharma Inc, Bristol-Myers Squibb Company, Celgene Corporation, Clovis Oncology, CTI BioPharma Corp, Dendreon Pharmaceuticals Inc, Eisai Inc, Exelixis Inc, Foundation Medicine, Genentech BioOncology, Genomic Health Inc, Gilead Sciences Inc, Halozyme Inc, ImmunoGen Inc, Incyte Corporation, Infinity Pharmaceuticals Inc, Ipsen Biopharmaceuticals Inc, Janssen Biotech Inc, administered by Janssen Scientific Affairs LLC, Jazz Pharmaceuticals Inc, Kite Pharma Inc, Lexicon Pharmaceuticals Inc, Lilly, Medivation Inc, a Pfizer Company, Merck, Merrimack Pharmaceuticals Inc, Myriad Genetic Laboratories Inc, NanoString Technologies, Natera Inc, Novartis, Novocure, Onyx Pharmaceuticals, an Amgen subsidiary, Pfizer Inc, Pharmacyclics LLC, an AbbVie Company, Prometheus Laboratories Inc, Puma Biotechnology Inc, Regeneron Pharmaceuticals Inc, Sanofi Genzyme, Seattle Genetics, Sigma-Tau Pharmaceuticals Inc, Sirtex Medical Ltd, Spectrum Pharmaceuticals Inc, Taiho Oncology Inc, Takeda Oncology, Tesaro Inc, Teva Oncology and Tokai Pharmaceuticals Inc.

    RESEARCH TO PRACTICE STAFF AND EXTERNAL REVIEWERS — The scientific staff and reviewers for Research To Practice have no relevant conflicts of interest to disclose.

    This educational activity contains discussion of published and/or investigational uses of agents that are not indicated by the Food and Drug Administration. Research To Practice does not recommend the use of any agent outside of the labeled indications. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications and warnings. The opinions expressed are those of the presenters and are not to be construed as those of the publisher or grantors.

    This activity is supported by educational grants from AstraZeneca Pharmaceuticals LP, Clovis Oncology, Genentech BioOncology, ImmunoGen Inc, Myriad Genetic Laboratories Inc and Tesaro Inc.

    Hardware/Software Requirements:
    A high-speed Internet connection
    A monitor set to 1280 x 1024 pixels or more
    Internet Explorer 11 or later, Firefox 56 or later, Chrome 61 or later, Safari 11 or later, Opera 48 or later
    Adobe Flash Player 27 plug-in or later
    Adobe Acrobat Reader
    (Optional) Sound card and speakers for audio

    Last review date: January 2018
    Expiration date: January 2019

    After completing the Post-test, learners may download and review the answers here in order to identify further areas of study.

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