Ovarian Cancer   

Considering the treatment of platinum resistant ovarian cancer as done in the AURELIA trial (Pujade-Lauraine et al., PMID 24637997).

Assuming low risk of progression to AML and eligible for low-risk chemotherapies per hematologic/oncology.

Front-line PARP inhibitor maintenance therapy discontinued without progression.

Do you prophylactically start all patients on B12, B-complex, and/or omega-3? If so, what dose? What about ice mittens and booties?

Genes such as ATM, CHEK2, PALB2, RAD51C/D, BRIP1 seem to show some potential increased risk of ovarian cancer. Should these patients under prophylacti...

s/p optimal debulking. If this was an early-stage cancer would it change your adjuvant therapy recommendations?

Recurrence picked up incidentally on CT. No germ line mutations, somatic tumor testing of node resulted negative. PET confirmed isolated recurrence

Do you extrapolate from first line maintenance studies for duration of therapy?

Does your practice vary based on risk status (low vs high risk) or specific mutation status (BRCA+ vs HRD+) given PAOLA subset analyses? 

What specific platforms for determining somatic BRCA and HRD status do you use for a patient who does not carry a germline BRCA mutation?

Are there clinical factors which help stratify? Does your practice vary based on mutation status (BRCA+ vs HRD+?)

How do the 5 year results of SOLO-1 at ESMO 2020 impact your recommendations?

Is MDS/AML risk increased with longer duration of therapy?

Given recent approval of niraparib (Zejula) for the maintenance treatment of adult patients with advanced epithelial ovarian, fallopian tube, or prima...

Based on recent PAOLA-1

SOLO1 trial studied stage 3/4 patients.

Or do you wait for platinum resistance?

Is it reasonable to use single agent carboplatin for elderly patients?

Would you approach this situation as synchronous primaries (eg. FIGO IA in both) or as a locally advanced endometrial cancer (FIGO IIIA)? What adjuva...