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Debate 6B - In Patients with BRCA-negative and HRD-negative Epithelial Ovarian Cancer, Should Molecular Profiling be Routinely Done to Guide Adjuvant Therapy?

No

from Section III - Ovarian Cancer

Published online by Cambridge University Press:  20 July 2023

Dennis S. Chi
Affiliation:
Memorial Sloan-Kettering Cancer Center, New York
Nisha Lakhi
Affiliation:
Richmond University Medical Center, Staten Island
Nicoletta Colombo
Affiliation:
University of Milan-Bicocca
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Summary

In the era of targeted medicine, the use of poly (ADP-ribose) polymerase (PARP) inhibitors in homologous recombination deficient (HRD) tumors has represented the first clinically actionable mutation in gynecologic malignancies. The dramatic results seen across multiple clinical trials completely changed the landscape of epithelial ovarian cancer (EOC) treatments in both primary and recurrent settings. For many, it has spawned hope that additional biomarkers would soon be discovered that could find similarly spectacular results in different patient populations. However, molecular profiling’s efficacy in selecting targeted therapies and its economic practicality are difficult to justify.

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Publisher: Cambridge University Press
Print publication year: 2023

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References

Flaherty, KT, et al. Molecular landscape and actionable alterations in a genomically guided cancer clinical trial: National Cancer Institute Molecular Analysis for Therapy Choice (NCI-MATCH). J Clin Oncol 2020;38(33):38833894.CrossRefGoogle Scholar
Lee, YJ, et al. Integrating a next generation sequencing panel into clinical practice in ovarian cancer. Yonsei Med J 2019;60(10):914923.CrossRefGoogle ScholarPubMed
Kuderer, NM, et al. Comparison of 2 commercially available next-generation sequencing platforms in oncology. JAMA Oncol 2017;3(7):996998.CrossRefGoogle ScholarPubMed
Haunschild, CE, et al. The current landscape of molecular profiling in the treatment of epithelial ovarian cancer. Gynecol Oncol 2020;160(1):333345.CrossRefGoogle ScholarPubMed
Wallbillich, JJ, et al. A personalized paradigm in the treatment of platinum-resistant ovarian cancer: a cost utility analysis of genomic-based versus cytotoxic therapy. Gynecol Oncol 2016;142(1):144149.CrossRefGoogle ScholarPubMed

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