· Although chemotherapy still appears in the majority of treatment strategies for these patients, the results of combinations with these new agents are revolutionizing the standard of current treatments
· The congress, which is being held online this year, will open its 7th edition with a review of the PAOLA-1, PRIMA and VELIA clinical trials, all with very promising results in ovarian cancer
· The debate between the American point of view, in favor of open surgery in cervical cancer, and the European perspective, more conservative and opting for minimally invasive surgery, will also be reflected during the meeting
The latest scientific meetings have agreed that PARP inhibitors are a very promising option, even when compared to chemotherapy, in the first line of treatment of ovarian cancer. For this reason, the debate on these drugs will be present at the 7th Congress on Gynecologic Oncology held by MD Anderson Cancer Center Madrid every two years in collaboration with its counterpart in Houston.
"The idea is to build a bridge between the American vision and the European vision regarding these pathologies," says Dr. Raul Marquez, head of the Gynecological Tumors Section of the Medical Oncology Service at MD Anderson Madrid and one of the three coordinators of this top international conference on the treatment of gynecological cancer which, having been postponed in March due to the pandemic, will be held online between November 11 and 13, 2020.
With an expected participation of some 275 professionals with very different medical specialties (medical oncology, gynecologic oncology, anatomic pathology, radiology, nuclear medicine, etc.) and from North America, South America, Europe and Asia, this meeting seeks to be a meeting point and exchange of experiences. “We can learn a lot from each other, understanding our differences and our similarities helps us optimize the care of these patients,” said Dr. Pedro T. Ramirez, of the Department of Gynecologic Oncology at MD Anderson Cancer Center Houston and another of the congress coordinators.
Dr. Javier de Santiago, head of the Gynecologic Oncology Service at MD Anderson Madrid, also explains that “the objective is not to organize a theoretical meeting, but rather a meeting that is useful for attendees, so they can get an idea of what can they offer their patients next week”. Dr. de Santiago is another of the congress coordinators along with Drs. Marquez and Ramirez.
Dr. Marquez will be in charge of opening the congress with a talk that aims to review the PAOLA-1, PRIMA and VELIA clinical trials. These three studies have yielded positive first-line treatment results for ovarian cancer and could mark a change in the standard of treatment. The idea is to generate a constructive debate that helps the scientific community to form a clear understanding of what these positive results mean and what they may imply in daily clinical practice.
This opening talk on ovarian cancer will end by discussing a topic that is also quite controversial. "We know that there are a certain number of patients who have a BRCA mutation and who could even avoid chemotherapy in favor of PARP inhibitors," says Dr. Marquez.
Another controversial issue that will be discussed at the meeting is the advisability of surgery for recurrent ovarian cancer. Dr. Robert Coleman will present the results of the first prospective, randomized study to conclude that the addition of surgery to chemotherapy treatment does not add any benefit to the survival rate of these patients. Likewise, another important issue to be discussed during the congress is the role of immunotherapy in ovarian cancer, which has so far obtained only modest benefits in the treatment of this type of tumor.
The relationship between surgery and survival in cervical cancer
In cervical cancer, the controversy resides in the use of open surgery or minimally invasive surgery. As Dr. de Santiago points out, "since last year, the scientific community has debated whether or not laparoscopic surgery might affect the survival of patients". In general terms, the United States has abandoned the practice of minimally invasive surgery and considers that open surgery should become the new standard of treatment, while European countries such as Spain, France or Germany continue to use minimally invasive techniques in selected patients. The preservation of fertility is one of the fundamental reasons why European countries continue to use minimally invasive surgery.