TARGET AUDIENCE
This activity is intended for medical oncologists and other healthcare providers involved in the treatment of ovarian cancer (OC).

OVERVIEW OF ACTIVITY
The American Cancer Society estimates that in 2017 more than 22,000 new cases of OC were diagnosed in the United States and more than 14,000 individuals died of the disease, making this the most lethal of the various gynecologic cancers. Fewer than 40% of women with OC are ultimately cured, and 70% of patients present with advanced disease, at which point palliation and improvements in quality of life are the primary goals of therapy. As with many other tumors, patient outcomes are critically dependent on effective multidisciplinary care, which in this case often includes contributions from gynecologic, medical and radiation oncologists as well as pathologists, diagnostic radiologists, oncology nurses and psychosocial services. In addition to the disease- and treatment-related morbidity and mortality associated with OC, pain, fatigue, lymphedema, depression/anxiety, infertility/childbearing and sexual dysfunction are commonly occurring issues that must also be addressed in the care of these patients.

To bridge the gap between research and patient care, this video presentation by Dr Ursula A Matulonis uses a review of recent relevant publications and presentations, ongoing clinical trials and clinical investigator treatment preferences to assist medical oncologists and other healthcare providers involved in the treatment of OC with the formulation of up-to-date clinical management strategies.

LEARNING OBJECTIVES

• Evaluate current standard therapies and emerging treatment options, and use this information to appropriately select and sequence therapeutic approaches for patients with recurrent OC.
• Describe the rationale for targeting angiogenic pathways in gynecologic cancers, and consider the role of the anti-VEGF antibody bevacizumab in the initial and long-term treatment of advanced OC.
• Use available guidelines and consensus statements to inform the selection of validated genetic testing platforms for patients with OC, and employ the resulting information to guide treatment planning and genetic counseling for these individuals.
• Understand the rationale for the investigation of PARP inhibitors as monotherapy for patients with BRCA mutation-positive advanced OC, and use this information to inform protocol and nonresearch treatment options for these individuals.
• Appreciate the FDA approval of rucaparib for patients with refractory advanced OC, and safely integrate this agent into clinical management as appropriate.
• Evaluate Phase III evidence supporting the use of PARP inhibitor maintenance therapy for patients with recurrent, platinum-sensitive OC with and without BRCA mutations who are responding to platinum-based chemotherapy.
• Recognize the mechanisms of action, emerging efficacy data and toxicity profiles of investigational agents and immunotherapeutic strategies for the treatment of OC, and counsel appropriately selected patients about the availability of ongoing clinical trials.

ACCREDITATION STATEMENT
Research To Practice is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

CREDIT DESIGNATION STATEMENT
CME credit is no longer available for this issue

AMERICAN BOARD OF INTERNAL MEDICINE (ABIM) — MAINTENANCE OF CERTIFICATION (MOC)
CME credit is no longer available for this issue

HOW TO USE THIS CME ACTIVITY
This CME activity consists of a video component.
CME credit is no longer available for this issue

CONTENT VALIDATION AND DISCLOSURES
Research To Practice (RTP) is committed to providing its participants with high-quality, unbiased and state-of-the-art education. We assess conflicts of interest with faculty, planners and managers of CME activities. Conflicts of interest are identified and resolved through a conflict of interest resolution process. In addition, all activity content is reviewed by both a member of the RTP scientific staff and an external, independent physician reviewer for fair balance, scientific objectivity of studies referenced and patient care recommendations.

FACULTY — The following faculty (and their spouses/partners) reported relevant conflicts of interest, which have been resolved through a conflict of interest resolution process:

Presenting Faculty Member

Ursula A Matulonis, MD
Medical Director and Program Leader
Gynecologic Oncology Program
Professor of Medicine
Harvard Medical School
Dana-Farber Cancer Institute
Boston, Massachusetts

Advisory Committee: 2X Oncology, Clovis Oncology, Geneos Therapeutics, The Clearity Foundation.

Project Steering Committee Members

Michael Birrer, MD, PhD
Director, UAB Comprehensive Cancer Center
University of Alabama at Birmingham
Birmingham, Alabama

Advisory Committee: Roche Laboratories Inc.

Robert L Coleman, MD
Professor and Vice Chair
Clinical Research
Ann Rife Cox Chair in Gynecology
Department of Gynecologic Oncology and Reproductive Medicine
The University of Texas
MD Anderson Cancer Center
Houston, Texas

Advisory Committee: Abbott Laboratories, AstraZeneca Pharmaceuticals LP, Bayer HealthCare Pharmaceuticals, Clovis Oncology, Genentech BioOncology, Janssen Biotech Inc, Merck, Roche Laboratories Inc; Contracted Research: Abbott Laboratories, AstraZeneca Pharmaceuticals LP, Clovis Oncology, Genentech BioOncology, Janssen Biotech Inc, Merck, Roche Laboratories Inc.

Don S Dizon, MD
Director, Women's Cancers
Lifespan Cancer Institute
Director, Medical Oncology
Rhode Island Hospital
Associate Professor of Medicine
Alpert Medical School of Brown University
Providence, Rhode Island

Consulting Agreement: Fujibio.

Thomas J Herzog, MD
Paul and Carolyn Flory Professor
Deputy Director
UC Cancer Institute
Vice Chair, Quality and Safety
Department of Obstetrics and Gynecology
University of Cincinnati
Cincinnati, Ohio

Advisory Committee: AstraZeneca Pharmaceuticals LP, Clovis Oncology, Johnson & Johnson Pharmaceuticals, Roche Laboratories Inc, Tesaro Inc.

Bradley J Monk, MD
Professor
Division of Gynecologic Oncology
Arizona Oncology (US Oncology Network)
University of Arizona College of Medicine - Phoenix
Creighton University School of Medicine at St Joseph's Hospital
Phoenix, Arizona

Consulting Agreements: Advaxis Inc, Amgen Inc, AstraZeneca Pharmaceuticals LP, Bayer HealthCare Pharmaceuticals, Clovis Oncology, Genentech BioOncology, Gradalis Inc, INSYS Therapeutics Inc, Mateon Therapeutics, Merck, Pfizer Inc, PPD, Precision Oncology, Roche Laboratories Inc, Tesaro Inc; Contracted Research: Amgen Inc, Array BioPharma Inc, Genentech BioOncology, Lilly, Janssen Biotech Inc, Johnson & Johnson Pharmaceuticals, Morphotek Inc, Tesaro Inc; Speakers Bureau: AstraZeneca Pharmaceuticals LP, Genentech BioOncology, Janssen Biotech Inc, Johnson & Johnson Pharmaceuticals, Roche Laboratories Inc.

Kathleen Moore, MD
Jim and Christy Everest Endowed Chair in Cancer Research
Director, Oklahoma TSET Phase I Program
Stephenson Cancer Center
Associate Professor
Section of Gynecologic Oncology
Director, Gynecologic Oncology Fellowship
Department of Obstetrics and Gynecology
University of Oklahoma Health Sciences Center
Oklahoma City, Oklahoma

Advisory Committee: AstraZeneca Pharmaceuticals LP, Roche Laboratories Inc.

Angeles Alvarez Secord, MD, MHSc
Professor, Department of Obstetrics and Gynecology
Division of Gynecologic Oncology
Duke Cancer Institute
Durham, North Carolina

Advisory Committee: AstraZeneca Pharmaceuticals LP, Genentech BioOncology, Janssen Biotech Inc, Tesaro Inc; Contracted Research: AbbVie Inc, Amgen Inc, Astellas Pharma Global Development Inc, Astex Pharmaceuticals, AstraZeneca Pharmaceuticals LP, Boehringer Ingelheim Pharmaceuticals Inc, Bristol-Myers Squibb Company, Eisai Inc, Endocyte Inc, Exelixis Inc, Genentech BioOncology, GlaxoSmithKline, Incyte Corporation, Merck, Morphotek Inc, Tesaro Inc.

PROJECT CHAIR — Dr Love is president and CEO of Research To Practice, which receives funds in the form of educational grants to develop CME activities from the following commercial interests: AbbVie Inc, Acerta Pharma, Adaptive Biotechnologies, Agendia Inc, Agios Pharmaceuticals Inc, Amgen Inc, Ariad Pharmaceuticals Inc, Array BioPharma Inc, Astellas Pharma Global Development Inc, AstraZeneca Pharmaceuticals LP, Baxalta Inc, Bayer HealthCare Pharmaceuticals, Biodesix Inc, bioTheranostics Inc, Boehringer Ingelheim Pharmaceuticals Inc, Boston Biomedical Pharma Inc, Bristol-Myers Squibb Company, Celgene Corporation, Clovis Oncology, CTI BioPharma Corp, Dendreon Pharmaceuticals Inc, Eisai Inc, Exelixis Inc, Foundation Medicine, Genentech BioOncology, Genomic Health Inc, Gilead Sciences Inc, Halozyme Inc, ImmunoGen Inc, Incyte Corporation, Infinity Pharmaceuticals Inc, Ipsen Biopharmaceuticals Inc, Janssen Biotech Inc, administered by Janssen Scientific Affairs LLC, Jazz Pharmaceuticals Inc, Kite Pharma Inc, Lexicon Pharmaceuticals Inc, Lilly, Medivation Inc, a Pfizer Company, Merck, Merrimack Pharmaceuticals Inc, Myriad Genetic Laboratories Inc, NanoString Technologies, Natera Inc, Novartis, Novocure, Onyx Pharmaceuticals, an Amgen subsidiary, Pfizer Inc, Pharmacyclics LLC, an AbbVie Company, Prometheus Laboratories Inc, Puma Biotechnology Inc, Regeneron Pharmaceuticals Inc, Sanofi Genzyme, Seattle Genetics, Sigma-Tau Pharmaceuticals Inc, Sirtex Medical Ltd, Spectrum Pharmaceuticals Inc, Taiho Oncology Inc, Takeda Oncology, Tesaro Inc, Teva Oncology and Tokai Pharmaceuticals Inc.

RESEARCH TO PRACTICE STAFF AND EXTERNAL REVIEWERS — The scientific staff and reviewers for Research To Practice have no relevant conflicts of interest to disclose.

This educational activity contains discussion of published and/or investigational uses of agents that are not indicated by the Food and Drug Administration. Research To Practice does not recommend the use of any agent outside of the labeled indications. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications and warnings. The opinions expressed are those of the presenters and are not to be construed as those of the publisher or grantors.

This activity is supported by educational grants from AstraZeneca Pharmaceuticals LP, Clovis Oncology, Genentech BioOncology, ImmunoGen Inc, Myriad Genetic Laboratories Inc and Tesaro Inc.

Hardware/Software Requirements:
A high-speed Internet connection
A monitor set to 1280 x 1024 pixels or more
Internet Explorer 11 or later, Firefox 56 or later, Chrome 61 or later, Safari 11 or later, Opera 48 or later
Adobe Flash Player 27 plug-in or later
Adobe Acrobat Reader
(Optional) Sound card and speakers for audio

Last review date: January 2018
Expiration date: January 2019