Robert L. Coleman, MD, on Looking Forward in Surgical Intervention for Ovarian Cancer

August 29, 2020
Robert L. Coleman

The US Oncology expert looks back on how far the ovarian cancer treatment space has come, and where it is headed.


Yeah. So we had a hard time trying to capture the value of all this new innovation. I know I spent a fair amount of time trying to understand how can we measure this because it doesn't get captured in incidents and death rates, it doesn't capture what we're seeing in the clinic. What we're seeing in a clinic are more and more patients alive with disease for longer periods of time. And so the statistic that measures that is called prevalence. And so disease prevalence has actually been increasing dramatically. It pivoted with the introduction of bevacizumab (Avastin), but it really pivoted again with the introduction of the PARP inhibitors.

What patients have to look forward to is that some of these interventions now are actually impacting overall survival. So not only are we developing therapies that are allowing women to live longer with cancer, we're also developing therapies for which a large proportion of patients are never going back on treatment. Of course, we need to follow this out farther, but I think the SOLO2 data, which was looking at the role of a olaparib (Zejula) in women who had responded to platinum chemotherapy and they received it as a maintenance. The fact that a 20% of those patients, at five years, still had not recurred is a phenomenal statistic.

We never had this conversation, you know, 10 years ago. So this is a remarkable achievement and change in the natural history of this disease. And so our hope is that if we keep stacking these kinds of improvements on top of each other, that we will continue to affect not only the expectation for five years, but now maybe start talking about 10-year survival. So patients have a lot to look forward to.

I encourage them as vehemently as I can, to help us by just participating in clinical trials that are looking for new ways. All of the drugs that I've talked about today got there because there were brave women and families who were generous enough to participate in these clinical trial activities. And yes, it changes the standard care, and we've had phenomenal success in the last five years. I've lived through it when we went through almost a decade with no new approvals to the point now that we're having two or three a year. It’s a tremendous blessing and honor to be able to participate in that process. But, you know, we couldn't do it without the patients.

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