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NCCN Guidelines Insights: Ovarian Cancer, Version 1.2019

Featured Updates to the NCCN Guidelines

Deborah K. Armstrong, Ronald D. Alvarez, Jamie N. Bakkum-Gamez, Lisa Barroilhet, Kian Behbakht, Andrew Berchuck, Jonathan S. Berek, Lee-may Chen, Mihaela Cristea, Marie DeRosa, Adam C. ElNaggar, David M. Gershenson, Heidi J. Gray, Ardeshir Hakam, Angela Jain, Carolyn Johnston, Charles A. Leath III, Joyce Liu, Haider Mahdi, Daniela Matei, Michael McHale, Karen McLean, David M. O’Malley, Richard T. Penson, Sanja Percac-Lima, Elena Ratner, Steven W. Remmenga, Paul Sabbatini, Theresa L. Werner, Emese Zsiros, Jennifer L. Burns, and Anita M. Engh

NACT Several prospective trials have explored whether adding bevacizumab to platinum-based regimens improves outcomes for patients treated with NACT. Preliminary results from GEICO 1205/NOVA found that adding bevacizumab to a standard carboplatin/paclitaxel

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Michael D. Stubblefield, Harold J. Burstein, Allen W. Burton, Christian M. Custodio, Gary E. Deng, Maria Ho, Larry Junck, G. Stephen Morris, Judith A. Paice, Sudhakar Tummala, and Jamie H. Von Roenn

. Available at: . Accessed: July 1, 2009 . 10 Ozols RF Bundy BN Greer BE . Phase III trial of carboplatin and paclitaxel compared with cisplatin and paclitaxel in patients with

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cancer, the NCCN Guidelines recommend intraperitoneal chemotherapy for first-line therapy and have been updated to include dose-dense paclitaxel (Taxol, Bristol-Myers Squibb) as a possible treatment option. Dr. Morgan noted that in a recent clinical

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Erica L. Mayer, Nancy U. Lin, and Harold J. Burstein

metastatic colorectal cancer . N Engl J Med 2004 ; 350 : 2335 – 2342 . 12. Sandler A Gray R Brahmer J . Randomized phase II/III Trial of paclitaxel (P) plus carboplatin (C) with or without bevacizumab (NSC # 704865) in patients with advanced

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Presenter: William J. Gradishar

and pictilisib, and the dual PI3K/mTOR inhibitor gedatolisib. Initial trials of the AKT inhibitors provided a mixed signal of efficacy. In the phase II PAKT2 trial, capivasertib + paclitaxel improved median OS from 12.6 months to 19.1 months (HR, 0

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William J. Gradishar

=.0067) but clinically modest 1.3-month progression-free survival benefit. 9 In the first-line setting of the BOLERO-1/TRIO 019 trial, trastuzumab/paclitaxel/everolimus did not improve progression-free survival overall. However, in the hormone receptor

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Bryan J. Schneider

. Phase III study of oral compared to intravenous topotecan as second-line therapy in small-cell lung cancer . J Clin Oncol 2007 ; 25 : 2086 – 2092 . 14. Dy GK Jett JR Geoffroy FJ . Topotecan and paclitaxel in previously treated patients

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Robert J. Morgan, Ronald D. Alvarez, Deborah K. Armstrong, Robert A. Burger, Mariana Castells, Lee-may Chen, Larry Copeland, Marta Ann Crispens, David Gershenson, Heidi Gray, Ardeshir Hakam, Laura J. Havrilesky, Carolyn Johnston, Shashikant Lele, Lainie Martin, Ursula A. Matulonis, David M. O’Malley, Richard T. Penson, Steven W. Remmenga, Paul Sabbatini, Joseph T. Santoso, Russell J. Schilder, Julian Schink, Nelson Teng, Theresa L. Werner, Miranda Hughes, and Mary A. Dwyer

to up-front therapy with carboplatin/paclitaxel or using bevacizumab as maintenance therapy; this disagreement is reflected as a category 3 recommendation. Most panel members believe that bevacizumab should not be added to up-front chemotherapy in

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Melinda L. Telli and Ronald M. Witteles

-stage disease settings. After its initial FDA approval in 1998 for first-line treatment of HER2-positive metastatic breast cancer in combination with paclitaxel, a series of pivotal adjuvant studies documented statistically significant improvements in both

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Lainie Martin and Russell J. Schilder

trap combined with paclitaxel strikingly inhibits tumor and ascites, prolonging survival in a human ovarian cancer model . Clin Cancer Res 2005 ; 11 ( 19 Pt 1 ): 6966 – 6971 . 30. Eleutherakis-Papaiakovou V Bamias A Dimopoulos MA