When to Consider a Clinical Trial if You Have Ovarian Cancer
When should ovarian cancer patients consider taking part in a clinical trial? “Always,” said David Starks, MD, MPH, with Avera Medical Group Gynecologic Oncology at Avera Cancer Institute in Sioux Falls.
“I tell patients they should always ask about clinical trials they could potentially qualify for and take part in,” Starks said.
“If there’s a clinical trial, that means there’s the possibility of a better treatment than what’s already available,” said Luis Rojas, MD, Avera gynecologic oncologist.
If you have ovarian cancer, your recommended treatment plan will include aspects like surgery and chemotherapy. Genomic testing might be recommended to further guide treatment decisions.
“Thanks to our participation in clinical trials, such as when we participated in PARP studies which showed an improvement in outcomes for some patients, our patients may see those benefits two or three years earlier than they normally would through an FDA-approved treatment.”
Treatment Options for Cancer of the Ovary
“If you’re a patient and you have cancer, you want to have as many good options in front of you as possible, and clinical trials can present those options,” Starks said.
Cancer patients are always offered standard of care, and participation in clinical trials is in addition to standard of care. “All patients need to be benefiting from the latest, evidence-based treatment protocols,” Rojas said.
Types of Clinical Trials
Avera Medical Group Gynecologic Oncology participates in numerous clinical trials through the National Cancer Institute (NCI) and those sponsored by pharmaceutical companies that are trialing cutting-edge medications, many of which will ultimately be approved and will improve the array of options for patients and their physicians. One example is immunotherapy.
“Research is happening at Avera and at a high level,” Starks said. This includes phase 3 trials, which tests how well a treatment works in comparison to standard treatment. “And we’re getting into earlier phase trials as well,” Starks added.
Striving for the Best Possible Outcomes
“Our goal as cancer physicians is how can we maximize this patient’s outcome,” Rojas said. Rojas and Starks look to partnerships through the NCI to enroll patients elsewhere if they feel they might benefit from a clinical trial that’s not currently offered through Avera.
PARP Inhibitors to Shrink Tumors
“We’ve seen some great success stories,” Rojas said. One example is a study in which ovarian cancer patients take a pill called a PARP inhibitor before surgery to shrink the tumor. Avera is the first U.S. site to take part in this international study.
“We enrolled a patient who had a spectacular response,” Rojas said. The surgeons could see significant spread of cancer in a first laparoscopy done to determine if the cancer was operable. Yet in the follow-up surgery after the patient took the PARP inhibitor pill, there was no cancer visible to the surgeons.
Cellular Therapy to Target Ovarian Cancer
Gynecologic oncologists have joined in collaboration with the Avera Medical Group Hematology, Transplant & Cellular Therapy team to offer cellular therapy through two new TIL (tumor infiltrating lymphocytes) studies.
“Specialized white blood cells called T cells are collected from the patient then reprogrammed and reinfused to specifically target the cancer,” Rojas explained. An ovarian TIL study is the first of its kind.
Potential Risks and Benefits
Patients go through a consent process that helps them understand the potential risks as well as the potential benefits of taking part in a study. Some clinical trials are discontinued if patients are not seeing the expected benefit. Patients may drop out if side effects are not worth the benefit.
“Newer drugs are always coming out, some with substantial benefit,” Starks said.
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