Appointment sheet
Platinum-sensitive ovarian cancer
Prepared with OnCo (onco.cc/prep/platinum-sensitive-ovarian-cancer/). Orientation, not medical advice; your team knows your case.
My details
Name
Date of appointment
Hospital and clinician
Who is coming with me
What I know, what is unclear, changes to discuss
Saved in this browserWhat I know so far
What is unclear to me
Changes since last time
My questions
24 on the sheetNewly diagnosed
- 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, Germline and somatic BRCA1 and BRCA2, HRD genomic instability score, CA-125 kinetics, AGO score for secondary surgery), 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?
First-line maintenance, BRCA-mutant
- 5.For my situation (first-line maintenance, brca-mutant), which of the standard options do you recommend and why?
- 6.Am I a candidate for Olaparib, Niraparib, and what side effects should I expect?
- 7.How do the results of SOLO-1 and PAOLA-1 / ENGOT-ov25 apply to someone like me?
First-line maintenance, HRD-positive BRCA-wild-type
- 8.For my situation (first-line maintenance, hrd-positive brca-wild-type), which of the standard options do you recommend and why?
- 9.Am I a candidate for Olaparib, Bevacizumab, Niraparib, and what side effects should I expect?
- 10.How do the results of PAOLA-1 / ENGOT-ov25 and PRIMA / ENGOT-OV26 apply to someone like me?
First-line maintenance, HRD-negative
- 11.For my situation (first-line maintenance, hrd-negative), which of the standard options do you recommend and why?
- 12.Am I a candidate for Niraparib, Bevacizumab, and what side effects should I expect?
- 13.How do the results of PRIMA / ENGOT-OV26 and GOG-0218 & ICON7 (bevacizumab) apply to someone like me?
First platinum-sensitive relapse
- 14.For my situation (first platinum-sensitive relapse), which of the standard options do you recommend and why?
- 15.Am I a candidate for Carboplatin, Pegylated liposomal doxorubicin, Gemcitabine or related drugs, and what side effects should I expect?
- 16.How do the results of DESKTOP III / ENGOT-ov20 apply to someone like me?
Relapse after PARP inhibitor
- 17.For my situation (relapse after parp inhibitor), which of the standard options do you recommend and why?
- 18.Am I a candidate for Carboplatin, Saruparib, and what side effects should I expect?
- 19.How do the results of ATHENA-MONO / GOG-3020 apply to someone like me?
Any stage
- 20.Are there clinical trials I could join, for example of Saruparib, ATR, WEE1, ctDNA-guided duration of PARP maintenance?
- 21.Would a second opinion at a high-volume centre change anything, and can you help arrange it?
- 22.What supportive care (symptom control, nutrition, exercise, mental health, financial help) is available from the start?
- 23.I read that “Whether HRD-negative tumours gain enough from PARP inhibitors to justify two to three years of treatment”. How does that affect my plan?
- 24.I read that “Resistance through BRCA reversion and restored homologous recombination”. How does that affect my plan?
The words I may hear
- Homologous recombination deficiency (HRD): A tumour that cannot properly repair double-strand DNA breaks, usually because of BRCA or related gene loss.
Tests and results to bring
Biomarker results to ask for: Platinum-free interval (over six months defines sensitivity), Germline and somatic BRCA1 and BRCA2, HRD genomic instability score, CA-125 kinetics, AGO score for secondary surgery (complete first resection, performance status, ascites), BRCA reversion mutations at progression on PARP inhibitor.
Scans and tests linked to this cancer: HRD & BRCA testing.
Bring copies of scan reports, pathology and blood results, and a list of every medicine and supplement.
The treatments I may be offered
- First platinum-sensitive relapse: Secondary cytoreduction in AGO-score-positive patients (DESKTOP III), then carboplatin doublet with pegylated liposomal doxorubicin, gemcitabine or paclitaxel, bevacizumab if not previously given, and PARP inhibitor maintenance if PARP-naive. (DESKTOP III / ENGOT-ov20, Carboplatin, Pegylated liposomal doxorubicin, Gemcitabine, Paclitaxel / nab-paclitaxel, Bevacizumab, Olaparib, Niraparib, Rucaparib)
- Relapse after PARP inhibitor: Platinum doublet; PARP rechallenge has limited benefit; trials of ATR, WEE1 and next-generation PARP1-selective inhibitors. (Carboplatin, Saruparib, ATR, WEE1, ATHENA-MONO / GOG-3020)
- First-line maintenance, BRCA-mutant: Olaparib for two years (SOLO-1), or olaparib with bevacizumab (PAOLA-1); niraparib as an alternative. (Olaparib, SOLO-1, PAOLA-1 / ENGOT-ov25, Niraparib, BRCA1 / BRCA2 (HRD), PARP inhibitors)
- First-line maintenance, HRD-positive BRCA-wild-type: Olaparib plus bevacizumab (PAOLA-1) or niraparib (PRIMA) after HRD testing. (Olaparib, Bevacizumab, PAOLA-1 / ENGOT-ov25, Niraparib, PRIMA / ENGOT-OV26, HRD & BRCA testing, Homologous recombination deficiency (HRD), PARP inhibitor + bevacizumab maintenance (HRD-positive))
- First-line maintenance, HRD-negative: Niraparib (PRIMA, smaller benefit) or bevacizumab; observation is reasonable after discussion. (Niraparib, PRIMA / ENGOT-OV26, Bevacizumab, GOG-0218 & ICON7 (bevacizumab))
From the standard of care recorded for this cancer; which apply depends on your stage and biomarkers. Ask which the team recommends and why.
Answers and next steps
Saved in this browserWhat I was told
Agreed next steps, dates and who to call