Dr Oliver Dorigo on New, Innovative Therapies in Gynecologic Cancers

Oliver Dorigo, MD, PhD, associate professor, obstetrics and gynecology, Stanford University Medical Center, discusses the use of PARP inhibitors and immunotherapy in gynecologic cancers.

Transcript

How have innovative new therapies changed the treatment landscape for gynecologic cancers?

I think that the new therapies that we now have approved, over the last 4 years in particular, have made a very valuable impact on patients. In particular, PARP inhibitors that are very effective in patients that have certain genomic mutations. Those patients are particularly patients with BRCA1 and 2 mutations, or patients that have certain genomic changes in the tumor that makes the tumor particularly sensitive to PARP inhibition. PARP inhibitors are oral drugs; we do like to give them after completion of chemotherapy for recurrent ovarian cancer, and we do now have several drugs approved.

We use this a fair amount in our clinical practice. These drugs are fairly new, so we still have to learn who the patients are that most benefit from these type of drugs, learn how to deal with the side effects, and how to use them most effectively. A lot of these drugs have not quite entered the first line treatment, but there are clinical trials going on that actually might show us that they are effective early on in the treatment process.

We’ve also used a fair amount of immunotherapy. Immunotherapy is a very young field, in particular gynecologic oncology, but in general we still need to understand who the patients are that benefit the most from immunotherapy. A number of immune checkpoint inhibitors have been approved for other solid tumors. We do need biomarkers to select those patients that can receive immunotherapy for gynecologic malignancies, but we do use immunotherapy, I would think quite a bit, in those patients that have no other treatment options. Immunotherapy is not without side effects, so I would say we need to be careful about what patients to treat, and again, who are the patients that benefit the most from these approaches.

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