Platinum-resistant ovarian cancer
Prepared with OnCo (onco.cc/prep/platinum-resistant-ovarian-cancer/). Orientation, not medical advice; your team knows your case.
My details
What I know, what is unclear, changes to discuss
Saved in this browserMy questions
22 on the sheet- 1.What is my exact diagnosis, stage, and grade, and which tests established them?
- 2.Which biomarkers have been tested on my tumour (for example Platinum-free interval under six months, Folate receptor alpha immunohistochemistry, PD-L1 combined positive score, Prior bevacizumab and PARP inhibitor exposure, CDH6, B7-H4 and TROP2 expression), and what were the results?
- 3.Which subtype is my cancer, and does that change the recommended treatment?
- 4.Is germline (inherited) genetic testing recommended for me or my family?
- 5.For my situation (folate receptor alpha-high), which of the standard options do you recommend and why?
- 6.Am I a candidate for Mirvetuximab soravtansine, and what side effects should I expect?
- 7.How do the results of MIRASOL / GOG-3045 apply to someone like me?
- 8.For my situation (pd-l1 cps 1 or more), which of the standard options do you recommend and why?
- 9.Am I a candidate for Pembrolizumab, Paclitaxel / nab-paclitaxel, Bevacizumab, and what side effects should I expect?
- 10.How do the results of KEYNOTE-B96 / ENGOT-ov65 apply to someone like me?
- 11.For my situation (any expression status), which of the standard options do you recommend and why?
- 12.Am I a candidate for Relacorilant, Paclitaxel / nab-paclitaxel, Pegylated liposomal doxorubicin or related drugs, and what side effects should I expect?
- 13.How do the results of ROSELLA / GOG-3073 apply to someone like me?
- 14.For my situation (later lines), which of the standard options do you recommend and why?
- 15.Am I a candidate for Raludotatug deruxtecan, Rinatabart sesutecan, Luveltamab tazevibulin or related drugs, and what side effects should I expect?
- 16.How do the results of REJOICE-Ovarian01 and RAINFOL-01 (Rina-S) apply to someone like me?
- 17.For my situation (supportive care), which of the standard options do you recommend and why?
- 18.Are there clinical trials I could join, for example of Raludotatug deruxtecan, REJOICE-Ovarian01, Rinatabart sesutecan, RAINFOL-01 (Rina-S)?
- 19.Would a second opinion at a high-volume centre change anything, and can you help arrange it?
- 20.What supportive care (symptom control, nutrition, exercise, mental health, financial help) is available from the start?
- 21.I read that “Sequencing antibody-drug conjugates that share topoisomerase or tubulin payloads”. How does that affect my plan?
- 22.I read that “Whether platinum resistance can be reversed rather than bypassed”. How does that affect my plan?
Tests and results to bring
Biomarker results to ask for: Platinum-free interval under six months, Folate receptor alpha immunohistochemistry (high expression required for mirvetuximab), PD-L1 combined positive score (pembrolizumab), Prior bevacizumab and PARP inhibitor exposure, CDH6, B7-H4 and TROP2 expression (antibody-drug conjugate trials), BRCA reversion mutations, CA-125 and imaging for response.
Bring copies of scan reports, pathology and blood results, and a list of every medicine and supplement.
The treatments I may be offered
- Folate receptor alpha-high: Mirvetuximab soravtansine with ophthalmic monitoring (MIRASOL). (Mirvetuximab soravtansine, MIRASOL / GOG-3045, Folate receptor alpha, Antibody-drug conjugate (ADC))
- PD-L1 CPS 1 or more: Pembrolizumab with weekly paclitaxel, with bevacizumab where not previously given (KEYNOTE-B96). (Pembrolizumab, Paclitaxel / nab-paclitaxel, Bevacizumab, KEYNOTE-B96 / ENGOT-ov65, PD-L1)
- Any expression status: Relacorilant with nab-paclitaxel (ROSELLA); or single-agent weekly paclitaxel, pegylated liposomal doxorubicin, topotecan or gemcitabine with bevacizumab if bevacizumab-naive (AURELIA). (Relacorilant, ROSELLA / GOG-3073, Paclitaxel / nab-paclitaxel, Pegylated liposomal doxorubicin, Topotecan, Gemcitabine, Bevacizumab)
- Later lines: Clinical trials of antibody-drug conjugates against CDH6, folate receptor alpha, B7-H4 and TROP2; hormonal therapy in receptor-positive low-grade disease. (Raludotatug deruxtecan, REJOICE-Ovarian01, Rinatabart sesutecan, RAINFOL-01 (Rina-S), Luveltamab tazevibulin, Letrozole (and other aromatase inhibitors))
- Supportive care: Early palliative care, drainage of ascites, management of bowel obstruction and nutritional support alongside anticancer treatment. (Ovarian cancer)
From the standard of care recorded for this cancer; which apply depends on your stage and biomarkers. Ask which the team recommends and why.