Assessment Tool for Maintenance Therapy in Ovarian Cancer

In advanced ovarian cancer, genetic testing rates hover around 50%.¹
Only 22.2% of patients received maintenance therapy in second line or greater therapy.²
Current rates warrant improved methods and practices to enable professionals to both identify and offer PARP-Inhibitors to appropriate patients at the right time. Please utilize instructions below to help with your patients.

Step 1: Run a report for ovarian cancer patients:

Select Electronic Medical Record (EMR) System for instructions

*This instructional guide represents a brief summary derived from NCODA practice member resources and does not substitute for the advice of your EMR provider and does not constitute or imply endorsement, recommendation, or favoring of operational considerations by NCODA. NCODA assumes no liability and does not ensure the accuracy of the information presented from the materials provided. Please consult with your EMR vendor related to this assessment initiative when implementing this assessment.

Step 2: Utilize NCODA PQI

Determine patient’s BRCA mutation status (consider genetic testing if not already completed)
Track all current or upcoming first-line platinum therapy patients with estimated completion date of their chemotherapy
Create a calendar reminder and maintain to mark the end of systemic therapy

Step 3:

Work closely and proactively with provider to determine each unique patient’s anticipated treatment plan
As completion date for current therapy approaches, assess treatment plan regarding maintenance therapy
Consider discussing treatment plan of maintenance options with provider
Consider monthly follow-up plan within the EMR during surveillance
When appropriate, ensure prescription for a PARP inhibitor is submitted
Consider PARP-Inhibitor utilization

Therapy	Ovarian Cancer Indications
Niraparib	For the maintenance treatment of adults with advanced epithelial ovarian, fallopian tube or primary peritoneal cancer who are in either complete or partial clinical response to first line platinum-based chemotherapy. Maintenance treatment of adults with recurrent epithelial ovarian, fallopian tube or primary peritoneal cancer who are in either complete or partial clinical response to platinum-based chemotherapy received second of later line setting in the gBRCAmut patient population.
Rucaparib	For the maintenance treatment of adult patients with recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer who are in a complete or partial response to platinum-based chemotherapy. For the treatment of adult patients with a deleterious BRCA mutation (germline and/or somatic)-associated epithelial ovarian, fallopian tube, or primary peritoneal cancer who have been treated with two or more chemotherapies.
Olaparib	For the maintenance treatment of adult patients with deleterious or suspected deleterious germline or somatic BRCA-mutated advanced epithelial ovarian, fallopian tube or primary peritoneal cancer who are in complete or partial response to first-line platinum-based chemotherapy. In combination with bevacizumab for the maintenance treatment of adult patients with advanced epithelial ovarian, fallopian tube or primary peritoneal cancer who are in complete or partial response to first-line platinum-based chemotherapy and whose cancer is associated with homologous recombination deficiency (HRD)-positive status defined by either: deleterious or suspected deleterious BRCA mutation, and/or genomic instability For the maintenance treatment of adult patients with recurrent epithelial ovarian, fallopian tube or primary peritoneal cancer who are in complete or partial response to platinum-based chemotherapy. For the treatment of adult patients with deleterious or suspected deleterious germline BRCA-mutate (gBRCAm) advanced ovarian cancer who have been treated with three or more prior lines of chemotherapy.

Step 4:

Visit online resources for more information and context in maintenance therapy in Ovarian Cancer
Examples:
- https://www.nccn.org/professionals/physician_gls/pdf/ovarian.pdf
- https://www.gemstoneoncology.com/

1. Randall LM, Aydin E, Louie-Gao M, Hazard S, Westin SN. A retrospective analysis of real-world tumor BRCA (tBRCA) testing trends in ovarian cancer before and after PARP inhibitor approvals. Presented at the 17th Biennial Meeting of the International Gynecologic Cancer Society; Kyoto, Japan: 2018.

2. Chase D, Perhanidis J, Gupta D, Kalilani L, Golembesky A, González-Martín A. Real-World Outcomes Following First-Line Treatment in Patients with Advanced Ovarian Cancer with Multiple Risk Factors for Disease Progression who Received Maintenance Therapy or Active Surveillance. Oncology and therapy. 2023;11(2):245-261. doi:https://doi.org/10.1007/s40487-023-00227-6.