RTP Mobile Logo
RTP On Demand: Current and Future Role of PARP Inhibitors in the Management of Ovarian Cancer (Video Program)
Released January 2017

Proceedings from video interviews with Drs Michael Birrer, Thomas J Herzog and Ursula A Matulonis on the treatment of ovarian cancer.

CE Disclosures and Faculty Information

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

    OVERVIEW OF ACTIVITY
    The American Cancer Society estimates that in 2016, 22,280 new cases of OC will be diagnosed in the United States and 14,240 individuals will die of the disease. Among all malignant ovarian neoplasms, epithelial OC is the most common form, representing approximately 90% of all cases. Primarily comprising serous, endometrioid and mucinous cystadenocarcinoma histologies, epithelial OC is the country’s fifth most common cause of cancer mortality in women. For this reason significant resources have been invested over the past few decades in attempts to better understand the natural history of the disease, identify genetic and other factors responsible for its proliferation and develop novel therapies with the potential to significantly improve outcomes for patients. One such avenue, investigating PARP inhibition as a mechanism to combat OC development and progression, ultimately paid impressive dividends with the 2014 FDA approval of the PARP inhibitor olaparib. Given the significant number of clinical and research questions created by this recent introduction and the rapidly expanding database surrounding PARP inhibition in general, it is clear that additional educational resources are needed to keep practicing clinicians up to date and informed. To that end, this special RTP On Demand program uses one-on-one discussion with leading investigators in the field to assist practicing clinicians with the formulation of up-to-date management strategies.

    LEARNING OBJECTIVES

    • Use available guidelines and consensus statements to develop an evidence-based algorithm for conducting genetic screening for patients with OC.
    • Understand the rationale for the investigation of PARP inhibition as monotherapy or in combination with other novel agents for patients with BRCA mutation-positive and BRCA wild-type advanced OC, and use this information to inform protocol and nonresearch treatment options for these individuals.
    • Appreciate the recent approval of olaparib for patients with highly refractory advanced OC, and appropriately integrate this agent into the clinical management of such cases.
    • Educate patients about the potential side effects associated with approved and investigational PARP inhibitors, and provide preventive and emergent strategies to reduce or ameliorate these toxicities.

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

    CREDIT DESIGNATION STATEMENT
    Research To Practice designates this enduring material for a maximum of 1.75 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

    AMERICAN BOARD OF INTERNAL MEDICINE (ABIM) — MAINTENANCE OF CERTIFICATION (MOC)
    Successful completion of this CME activity enables the participant to earn up to 1.75 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.

    HOW TO USE THIS CME ACTIVITY
    This CME activity consists of a video component. To receive credit, the participant should 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/RTPODOvarian116/Video/CME.

    CONTENT VALIDATION AND DISCLOSURES
    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:

    Michael Birrer, MD, PhD
    Professor, Medicine
    Harvard Medical School
    Director, Gillette Center for Gynecologic Oncology
    Massachusetts General Hospital
    Boston, Massachusetts

    Advisory Committee: Acceleron Pharma, AstraZeneca Pharmaceuticals LP, ImmunoGen Inc, Merrimack Pharmaceuticals Inc, OXiGENE Inc, Roche Laboratories Inc, Sanofi, Threshold Pharmaceuticals Inc.

    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: Amgen Inc, AstraZeneca Pharmaceuticals LP, Caris Life Sciences, Pfizer Inc, Roche Laboratories Inc.

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

    Advisory Committee: AstraZeneca Pharmaceuticals LP, Genentech BioOncology, ImmunoGen Inc, Merck.

    EDITOR — 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, Agendia 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, Daiichi Sankyo Inc, Dendreon Pharmaceuticals Inc, Eisai Inc, Exelixis Inc, Foundation Medicine, Genentech BioOncology, Genomic Health Inc, Gilead Sciences Inc, Halozyme Therapeutics, ImmunoGen Inc, Incyte Corporation, Infinity Pharmaceuticals Inc, Janssen Biotech Inc, Jazz Pharmaceuticals Inc, Lilly, Medivation Inc, Merck, Merrimack Pharmaceuticals Inc, Myriad Genetic Laboratories Inc, NanoString Technologies, Natera Inc, Novartis Pharmaceuticals Corporation, Novocure, Onyx Pharmaceuticals, an Amgen subsidiary, Pharmacyclics LLC, an AbbVie Company, Prometheus Laboratories Inc, Regeneron Pharmaceuticals, Sanofi, Seattle Genetics, Sigma-Tau Pharmaceuticals Inc, Sirtex Medical Ltd, Spectrum Pharmaceuticals Inc, Taiho Oncology Inc, Takeda Oncology, Tesaro Inc, Teva Oncology, Tokai Pharmaceuticals Inc and VisionGate 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 grantor.

    This activity is supported by an educational grant from Tesaro Inc.

    Hardware/Software Requirements:
    A high-speed Internet connection
    A monitor set to 1280 x 1024 pixels or more
    Internet Explorer 7 or later, Firefox 3.0 or later, Chrome, Safari 3.0 or later
    Adobe Flash Player 10.2 plug-in or later
    Adobe Acrobat Reader
    (Optional) Sound card and speakers for audio

    Last review date: January 2017
    Expiration date: January 2018

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

Acknowledge and close

Watch video
(WIFI is recommended for best performance):
Treatment strategies in the management of ovarian cancer (OC)
Topics:
  • MITO8 Phase III study testing the effect on survival of prolonging the platinum-free interval for patients with OC
  • OV21/PETROC Phase II study evaluating intraperitoneal versus intravenous chemotherapy after neoadjuvant chemotherapy and optimal debulking surgery
Mechanism of action of PARP inhibitors and importance of BRCA testing
Topics:
  • Somatic versus germline BRCA mutations and correlation with response to PARP inhibitors
  • Evolving role of homologous recombination deficiency assays in the management of OC
  • BRCA testing for patients with OC and the role of PARP in DNA repair
  • Synthetic lethality in PARP inhibition for patients with OC lacking BRCA1/2 mutations
  • Perspective on the importance of up-front BRCA testing for patients with epithelial OC
PARP inhibitors as primary treatment after multiple lines of therapy
Topics:
  • A 54-year-old woman undergoes optimal debulking surgery, experiences disease progression through multiple lines of chemotherapy and is determined to have BRCA-positive disease
  • A 55-year-old woman undergoes optimal cytoreductive surgery, receives multiple lines of chemotherapy and then receives olaparib on a clinical trial
PARP inhibitors as maintenance therapy
Topics:
  • Niraparib maintenance therapy for platinum-sensitive, recurrent OC
  • PARP inhibitors as maintenance therapy for platinum-sensitive, relapsed OC
  • Clinical implications of the ENGOT-OV16/NOVA trial results: Niraparib maintenance therapy for platinum-sensitive, recurrent OC
Tolerability of olaparib
Topics:
  • Second opinion: A 45-year-old woman with optimally debulked Stage IIIA serous OC with a germline BRCA2 mutation and no evidence of disease after adjuvant chemotherapy desires maintenance olaparib
  • Second opinion: Monitoring blood counts in patients receiving olaparib and the use of erythropoiesis-stimulating agents
  • Management of nausea and vomiting in patients receiving olaparib
Treatment options after olaparib failure
Topics:
  • Second opinion: Therapeutic options for patients experiencing disease progression on olaparib
Differences among PARP inhibitors
Topics:
  • Perspective on approved and investigational PARP inhibitors
  • Differences in form, strength and number of pills or capsules administered per day among approved and investigational PARP inhibitors
  • Comparison of side effects with olaparib, rucaparib and niraparib
  • Potency and side-effect comparison of PARP inhibitors
Future directions in OC research
Topics:
  • Investigational strategies with anti-PD-1 checkpoint inhibitors in OC