Conférence - Ovarian Cancer Research Alliance | OCRA

Christine

@Francy@Elise54 @Barbara @Sandrina @jojo02 @Lulu22 @LuLuLu @Danie et les autres soeurs turquoises

Bonjour,

La "petite soeur" américaine de Cancer de l'ovaire Canada, la Ovarian Cancer Research Alliance(OCRA) a tenu sa conférence du 1er au 3 novembre 2023.  Cela fait un bout de temps que je veux mettre le résumé qu'une amie, Helen Palmquist, m'a fait parvenir (avec sa permission biensûr). Prendre note que ce sont ses notes personnelles, il peut donc y avoir des erreurs.  Je joins également les hyperliens à l'agenda et aux présentations des experts.  Le tout est en anglais seulement.

Bonne lecture! 

Christine

Résumé d'Helen Palmquist

2022 OCRA CONFERENCE - My Notes - Please excuse any errors

What’s New in Ovarian Cancer Research, Treatment and Survivorship

Stephanie Blank – Mt. Sinai

High grade serous = 70 to 75%

There have been more drug approvals since 2014

PREVENTION – genetic testing, test family members, risk reducing surgery – remove tubes, oral contraceptives

3000 counties in US without gyn/oncs.

Maintenance is not for everyone – Avastin – PARPS

30% of ovarian is HRD Somatic – look at tissue Genetic – look at blood = determines receive PARP

SOLO 1 Study - determine if use PARP (2 years). 20% more likely disease not progress. Progression Free Survival – 2 years if BRCA positive, Progression Free Survival – 1 year if HRD

Recurrence- There is no one choice treatment for recurrence. PARP may still help after recurrence.

Immunotherapy not as effective as hoped for ovarian cancer

Trial- using Avastin + Cytoxan ADC- Deliver chemo directly to tumor – toxic – Mirvetuximab

Managing Recurrence – Sarah Adams – University of New Mexico

To determine if use neoadjuvant – where disease is located, health and age of patient

Maintenance – use Avastin, PARP or both

See gyn/onc once every 3 months first 2 years, 3rd year – see gyn/onc every 4 months – see gyn/onc every 6 months up to 10 years.

Stage III – 68% recur if optimally debulked 88% recur if not optimally debulked

Recurrence symptoms – bloating , pelvic pain, lymphodema, double CA125

61% of women diagnosed with recurrence – based on elevated CA125, also do CT, MRI or PET scan

Options for treating recurrence – 1. surgery, chemo targeted therapy. Surgery for bowel obstruction, limited sites of recurrence, long treatment free intervals. 2. Chemo – second line treatment if platinum resistant such as Gemzar, Doxil, Topotecan, Etoposide, Avastin

Targeted Agents – Avastin – Bevacizumab – 6 months PFS – Progression Free Survival 20 – 40%

PARP – block DNA repair. Best response – those with BRCA mutation, delay recurrence

Immune Therapy - only used in trials, targets immune cells, cancer vaccines, Tcell therapy

Hormone Therapy – Tamoxifen, response 17 to 20%

When treat Recurrence – 2010 European study – Does earlier treatment improve Survival? No

Small volume of disease – wait to start treatment

TRIALS – Phase 1 – safety and tolerable. Phase 2 – dose findings. Phase 3 – Compare one drug to another drug. Standard drug vs new drug

Emerging Therapies: 1. Antibody drug conjugate 2. Immunotherapeutic strategies 3. Combine regimens

Rare Cancers – Clear Cell – easier to treat stage 1a. Need to be aggressive for stage III.

Low Grade – use Letrozole Granulosa – surgery + radiation.

Ask The Experts – Dinl Khabele – Washington U, ST. Louis, Mogre – U. of Oklahoma, Diane Yomato – U. of Chicago

Early Detection – Nothing changed. Working on liquid biopsy – vaginal swab.

Staging & Recurrence – optimally debulked – removing all visable tumor (no tumor left larger than a centimeter).

Muscinus – resistant and harder to treat. Sometimes found early.

Clear cell also harder to treat.

Neoadjevant – Imaging and laproscopy determine whether to do surgery first. If believe cannot remove all visible disease then do neoadjevent. 7% of the time (somatic) mutation found in tumor.

Maintenance – Epithelial, If test positive for a BRCA mutation then often respond well to platinum drugs and PARP Inhibitor.

Solo Trial – 7 year follow up – 50% alive after using PARP

Avastin + Olaparib – 5 year data. Large number not recur. Patients who want to continue PARP and or Avastin – more is not always better. Avastin can cause perforation of bowel with prolonged use. PARPS can cause bone marrow damage. PARPS work best on BRCA + and HRD +.

If negative for BRCA and HRD then use Avastin.

80% respond to platinum drugs. For those who are platinum resistant – other drugs are being studied to use with Taxol such as antibody congegants – potent

Immenotherapy has been disappointing for ovarian cancer – T cells to fight protein. Enzymes from proteins to fight cancer.

Access to Clinical Trials – 1. OCRA 2. Foundation For Womens Cancer

Low Grade - only 10% have low grade. Use Letrozole instead of chemo or use Letrozole after chemo.

MANAGING RECURRENCE – DR. Sarah Adams – New Mexico

Avastin – used as maintenance or for recurrence

HIPEC – for muscinus under investigation. Not for recurrence.

All people with ovarian cancer should have genetic testing.

Repeating a PARP is being studied.

Progression Free Survival – CA125 + scans. If have progression then go off trial.

Toxsisity to chemo – Can become hypersensitive to Taxol. Can become hypersensitive to Carbo after dose 6, 7 or 8. Taxol can cause neuropathy.

Use scans and CA125 instead of 2nd look surgery.

Low Grade Maintenance – use hormone treatment – Tamoxifen

Biochemical Recurrence – CA125 goes up but nothing shows on scan. Sometimes CA125 high with no disease and sometimes CA125 is low with lots of disease.

Hormonal Therapy – to stabilize disease. Maintenance - use PARP or Avastin after recurrence.

Granulosa – good outcomes – slow growing

Stromal – do 2nd surgery. Use hormone therapy

How long on PARPS – 2 years. Maybe safe to stay on longer.

PARPS used more for maintenance than for recurrence

Avastin – can cause perforation if tumor invading bowel wall.

If CA125 is not a good marker then use internal exam, symptoms, and scan

Trial – liquid biopsy – show changes in tumor.

When disease is in lymph nodes treat same as when not in lymph nodes.

Use a PET scan if a person had radiation.

If have long progression Free Survival then platinum sensitive and can use PARP. Not use radiation if disease is widespread.

CART cells – modify T cells – not work for ovarian yet.

MANAGING SYMPTOMS - Lori Spoozak – Palliative Care – living with serious illness

Quality of life – Goals – short and long term

Palliative – for those with 1. Disease spread 2. Recurrence 3. When stop treatment 4. any time

How much time left – depends on how respond to treatment

Slowing down, sleeping more, lack of energy, no desire to eat

When dying – chemo can shorten life

Hospice – when have 6 months or less, most often at home, nurses manage care 1 to 3 times a week, social worker

EARLY DETECTION – Dr. Deborah Armstrong – Johns Hopkins Dr. Castle – NCI

The risk of ovarian in US general public – 1 to 2% Family history – 3 to 5%

Easily get a sample for PAP and HPV – cervical – preventable

Ovarian can be shed from normal cells

CA125 – not a screening tool, too many false positivies

1. Ultra sound screening – not reduce mortality

2. CA125 + ultrasound not reduce mortality = only find benign disease

Need different strategy – just like pancreatic, ovarian is hard to image

In UK – studying liquid biopsy tests for cancer, biomarkers in blood, looking at DNA in fallopian tube, falopascope.

It took 25 years to find HPV vaccine

If BRCA positive then have preventative surgery. Remove fallopian tubes to reduce risk& remove ovaries later. This may reduce the number of women getting ovarian cancer.

STS – SURVIVORS TEACHING STUDENTS

947 VOLUNTEERS, 91 in Australia, in 40 US states

Going into nursing schools

Update program language – new power point

Knowing symptoms does NOT save lives. Now emphasize RISK ASSESMENT – if high risk – remove tubes and ovaries later.

Looking more at prevention than symptom

Agenda
https://ocrahope.org/patients/support-education/national-conference/2023-agenda/

Présentations des experts
https://ocrahope.org/patients/support-education/national-conference/2023-ovarian-cancer-national-conference-videos/

Christine

Allô @Barbara

ton message est malheureusement vide! 🥹

problème avec ovdialogue.

jojo02

Fancy

Bon samedi matin @jojo02!

Malheureusement, OVdialogue fait face à des enjeux techniques, et l'utilisation de cellulaires pour publier vos messages est en cause.

(comme tu peux le constater, la fenêtre juste en haut de celle-ci est vide)

Je t'encourage donc à utiliser un portable, un ordinateur personnel, ou même une tablette si tu le peux, le temps que la situation revienne à la normale.

En principe, les correctifs seront appliqués dès lundi.

Désolée pour ces inconvénients! J'espère que tu vas bien.

Bon samedi à toi!

Fancy