SEOM clinical guideline in ovarian cancer (2020)

Abstract

Despite remarkable advances in the knowledge of molecular biology and treatment, ovarian cancer remains the leading cause of death from gynecologic cancer. In the last decade, there have been important advances both in systemic and surgical treatment. However, there is no doubt that the incorporation of PARP inhibitors as maintenance after the response to platinum-based chemotherapy, first in recurrent disease and recently also in first line, will change the natural history of the disease.The objective of this guide is to summarize the current evidence for the diagnosis, treatment, and follow-up of ovarian cancer, and to provide evidence-based recommendations for clinical practice.

Olaparib as first line in BRCA-mutated advanced ovarian carcinoma: Is it cost-effective in Spain?

“…These results are in line with recent studies, concluding that maintenance treatment with targeted therapies in advanced OC patients can be cost-effective [42]. In conclusion, our results support the strong recommendation of SEOM guidelines [15] about the use of olaparib as first-line maintenance treatment in patients with advanced HGSOC BRCA mutated-with a cost-effective ICER of €14,653.2/QALY, according to the cost-effectiveness threshold considered in Spain [20,21].…”

“…In addition, our study included all oncology visits and follow-up tests required for patients in both scenarios (stable patients and those showing progression), based on the time interval since the administration of the first-line maintenance treatment (Table 2) [15]. Finally, it was assumed that palliative care is given to the patients in their last 48 days (terminal phase) [26].…”

“…The study showed that treatment with olaparib tablets (300 mg twice daily) provided a substantial benefit, with a statistically meaningful 70%-reduction in the risk of disease progression or death in comparison to placebo with consistent and known adverse events profile [13]. As a result, olaparib was authorized by EMA in June 2019 and was recommended as first-line maintenance treatment in the National Comprehensive Cancer Network (NCCN) guidelines [14], and in the recent Spanish Medical Oncology Society (SEOM) guidelines [15]. In addition, its cost is predictable, because it has a flat-fixed dose and a maximum treatment duration of 24 months [16].…”

Radix ranunculus temate saponins sensitizes ovarian cancer to Taxol via upregulation of miR‑let‑7b

“…Ovarian cancer is the leading cause of mortality in gynecological malignancy ( 27 ). The front-line treatment for ovarian cancer is primarily surgery, supplemented by chemotherapy ( 28 ).…”

Prolonged Exposition with Hyperthermic Intraperitoneal Chemotherapy (HIPEC) May Provide Survival Benefit after Cytoreductive Surgery (CRS) in Advanced Primary Epithelial Ovarian, Fallopian Tube, and Primary Peritoneal Cancer

“…Furthermore, the French clinical practice guideline recommends the use of HIPEC in the case of initially nonresectable FIGO stage III ovarian, tubal, and primary peritoneal carcinoma after a complete or optimal interval surgery, which is performed after three cycles of intravenous chemotherapy [ 11 ]. While other national guidelines do not even consider this therapeutic option [ 12 , 13 ], some, such as in Germany, recommend the application of HIPEC only in the context of prospective randomized studies [ 14 ]. Similarly, the recently published recommendation of European Society for Medical Oncology (ESMO) and European Society of Gynecological Oncology (ESGO) consensus on ovarian cancer failed to recommend HIPEC as a standard of care for the first-line management of patients with advanced-stage epithelial ovarian cancer [ 3 ].…”