In the year 2020, we have witnessed an unprecedented evolution in medicine, as we adjusted our clinical practices, research programs, and educational vehicles to meet the challenges of the COVID-19 pandemic.
Our patients continued to fight ovarian cancer bravely as we provided them with additional support for their emotional and physical vulnerabilities. Over the past year, we have been acutely aware that our patients are susceptible to infection due to immunosuppression, recent surgery, chemotherapy, and the side effects of treatment, and we were driven to adapt quickly to meet their unique needs during this crisis.
Obvious disruptions due to COVID-19 were magnified by stay-at-home orders, as healthcare providers supported statewide emergency orders to avoid overwhelming our medical facilities and depleting resources needed for critically ill patients.
From a clinical perspective, we saw a rise in telemedicine, which improved the management of infections and chronic comorbid healthcare conditions. Many of us met virtually and developed more collaborative healthcare approaches; some of us increased the use of medications that could be prescribed electronically.
For those of us involved in research, many witnessed the challenges of complying with procedures directed by safety protocols put in place for COVID-19.
Finally, the means of disseminating advances in cutting-edge treatment normally presented in live scientific forums changed drastically. National and international meetings, such as the American Society of Clinical Oncology (ASCO), the European Society for Medical Oncology (ESMO), and the European Society of Gynaecological Oncology (ESGO), convened virtually this year and utilized flexible but abbreviated formats to deliver research on oncology care advancements.
To support you in your clinical practice as you seek to optimize ovarian cancer care, we are distilling the research in this Year in Review series, and synthesizing the most important findings from these meetings.
A brief review of a few studies are discussed in this issue, with a focus on recent advances, potentially practice-changing developments, and ongoing challenges in ovarian cancer management.
Interesting new data about PARP inhibitors continues to provide us with hope. Exciting new data demonstrated that when utilized as maintenance therapy after frontline treatment of ovarian cancer in patients with BRCAwt tumors, niraparib improved progression-free survival in even the most difficult-to-treat subgroup of patients.
However, we were challenged by the findings of real-world use of PARP inhibitors, which contrasted to the criteria and outcomes of clinical trial results. In both platinum-sensitive and platinum-resistant settings, post PARP inhibitor treatment outcomes were inferior. This study highlighted the critical need to identify differences between clinical trials and clinical practice, so specific tactics can be incorporated into real-world settings to improve outcomes.
We will continue to learn from the challenges we encountered in 2020, and we will apply these lessons to the perennial challenges faced in diagnosis, treatment, and management. We hope that you enjoy these highlights!
Amina Ahmed, MD
Associate Professor, Department of OBGYN, Division of Gynecologic Oncology
Director, Cancer Service Line
Rush University Medical Center