Thursday, August 15, 2019

Nirapamib for Maintenance Therapy: New Evidence that All OC Women Would Benefit

This article by Dr. Oliver Dorigo from Stanford University Medical Center, was found on Survivornet.com

When I was diagnosed 4 years ago options for maintenance therapy were generally limited to women who were BRCA+.  Not so any more with this particular PARP. Avastin was also available but the data was not strong enough to support me being on it, according to my surgeon. I was Stage 3C and the plan was for me to undergo surgery followed by IV/IP treatment, all of which I completed.

Maintenance therapy is becoming more standard however and so, four years out, there is  nothing in the article to suggest that women like me begin maintenance.

Here's what Dr. Dorigo has to say about Nirapamib:

After undergoing surgery and getting chemotherapy for ovarian cancer, you may want to consider taking a relatively new kind of drug called a PARP inhibitor, which helps to kill off cancer cells. “PARPs” are somewhat recent entrants into ovarian cancer treatments and are getting lots of attention from oncologists.
What are PARPs For?
While PARP inhibitors were originally approved to treat cancer recurrence in BRCA mutated patients with at least 2 or 3 prior lines of chemotherapy, there is compelling new evidence that all ovarian cancer patients, regardless of BRCA mutation, may want to consider PARP inhibitors for maintenance if they’re responding well to chemotherapy (including a platinum drug such as Carboplatin).
We spoke to Dr. Oliver Dorigo, a Gynecologic Oncologist at Stanford Medical School, about some of the details:
Niraparib as late-stage therapy for women without BRCA mutations:
Niraparib, also known as Zejula, is one of the three major PARP inhibitors, and can be used in patients without BRCA mutations (about 80% of women). According to Dr. Dorigo, “We have trials that have shown that Niraparib in any patient with [ovarian cancer] can be beneficial in the maintenance setting…independent of a BRCA mutation.” Tumor cells with BRCA mutations have problems repairing DNA already, and the PARP inhibitors make these cells even less functional, causing cancer cells to die. Nonetheless, Niraparib has been shown to be effective in patients without this mutation. The other two PARP inhibitors, Olaparib and Rucaparib, are also approved to be used in this setting with the same indications.
The drug is currently approved for use as maintenance therapy for advanced/recurrentovarian cancer patients, regardless of whether they have BRCA mutation. These patients have undergone initial surgery and multiple rounds of chemotherapy, but their cancer continues to come back. In fact, in one trial known as the NOVA trial, patients without BRCA mutation who had already undergone several rounds of chemotherapy lived more than twice as long after taking Niraparib as those who did not. Niraparib, like other PARP inhibitors, is used to block the ability of tumor cells to repair DNA, thus eventually killing them.
Niraparib as an ‘up-front’ therapy for women without BRCA mutations:
Niraparib is also being tested in a clinical trial for use after just the first line of chemotherapy. Doctors refer to PARP inhibitors used at this early stage in the treatment course as the drug being given ‘up-front.’ According to Dr. Dorigo, the trial, called the PRIMA trial, is looking at whether Niraparib can be used in ovarian cancer patients directly after the first round of chemotherapy following surgery, regardless of whether they have a BRCA mutation. Although the results have not been presented or published yet, Dorigo and other specialists believe that there is hope for the use of this drug in this setting. 


Tuesday, August 13, 2019

Application Forms for 2019 TTT Available Here

Hi folks,
Well after many hours of figuring out how to convert these forms to be able to post on our website, I think I've done it!

There are three forms that must be completed and sent in along with your check for $150 to secure your spot.

To find out more info about our fabulous camp, you can check it out by clicking on the page about the 2019 Retreat.

In the meantime, I'm including just the 3 forms along with an instruction sheet. You can print them off and if the IT gods have been smiling on me, you should be able to fill our these forms on line and send them as an attachment to Sue or Christine.

Here are the forms:

Can't wait to see old and new friends there!!!!

Evaluating Bevacizumab and PARP Inhibitors as Important Treatment Options

The following is a transcript by Dr. Michael Birrer, taken from Survivornet.com. Dr. Birrer, formerly medical director of gyn/onc and the gyn/onc research program at MGH, is now at the University of Alabama.

How do you decide what patients should get bevacizumab versus PARP? And that's really the million dollar question, and it's a very unique question. 
For those of us treating ovarian cancer patients, for almost 20 years, all we had was Carboplatin and Taxol. 
And we would argue about what taxane to use, or we might argue about IP versus IV. 
But there weren't really earth-shattering questions. 
Now we have choices, so it's terrific for the patients. 
But nevertheless, one needs to make that choice. 
And I think that the field is migrating that if patients have either germline or somatic BRCA1 gene mutations, that when possible, they should get a PARP inhibitor. 
However, you need to recognize you're looking at about 20% of the patient population. 
The other 80%, you need options. 
And there is where one might consider bevacizumab. 
Now does everybody get bev? Probably not, if you have certainly tumor infiltrating the bowel or other contraindications that might be risky. 
But again, that's a small patient population. 
So that's the way most of us are dividing this down. 
Genetic abnormalities giving rise to ovarian cancer-- BRCA1, BRCA2-- will get PARP inhibitor maintenance. 
And if they don't, they should be offered bevacizumab. 
What's the next step? And would there be an option to give both? The answer is, absolutely. 
So there are several ongoing trials looking at the combination of olaparib with bevacizumab, so we'll know the answer to that. 
If I were to give an educated guess, I would say we'll be treating with both agents in the near future.

Monday, July 29, 2019

Are You Currently Taking Zejula?

Survivornet.com is working with Tesaro, the makers of Zejula. Survivornet is editorially independent but has been hired by Tesaro to interview women who are currently taking Zejula.

They are not asking women to be positive or negative about the medication or asking them about their experiences with side effects etc.

Survivornet will pay you $1,000 for your time and effort and cover all your expenses to bring you out to NY. You would be videoed and essentially have 2 lines to say: 1) you are currently taking Zejula for either maintenance or recurrence of OC and 2) to contact Tesaro for more information to see if this medication is appropriate for you.

If you are interested, Survivornet would like to do the filming on August 16, 2019 but this could be negotiated. For more information, contact Alex Buxton at 929-304-9400 or via email at alex.buxton@survivornet.com