Conquering "silent killers" in gynecological tumors, are we still far?

Ovarian cancer is known as the "silent killer".
Because of its insignificant early clinical symptoms, most ovarian cancer patients are at an advanced stage of the disease when they are first diagnosed.
Few options are also an important factor in its high mortality [1]
.

The long-term prognosis of patients is at great risk
.

Open a new starting point.
First-line targeted maintenance therapy has made ovarian cancer "70% recurrence in 3 years" into history.
Ovarian cancer is one of the common malignant tumors in the female reproductive system in China, with high recurrence rate, high mortality, and low 5-year survival rate [2]
.

The initial standard treatment for advanced ovarian cancer is mainly surgery and chemotherapy, but the prognosis of patients is generally poor, and most patients will still relapse in a short time
.

Once relapsed, the available treatment options are limited, and patients often die due to relapsed drug resistance
.

Therefore, the ability to delay the recurrence of first-line treatment-naïve patients has become the key to improving the prognosis of ovarian cancer patients
.

Fortunately, with the progress and application of targeted therapy research, new breakthroughs have been achieved in the treatment of ovarian cancer
.

At present, studies such as SOLO-1 have verified the effect of PARP inhibitors in the treatment of ovarian cancer
.

The 5-year follow-up results of the SOLO1 study were published at ESMO 2020
.

Results showed that first-line BRCA-mutated ovarian cancer patients had median progression-free survival of more than 4.
5 years (56 months) with maintenance therapy with a PARP inhibitor compared to placebo, which was 42.
2 months longer than placebo, and 48% of patients have not relapsed after 5 years, and these patients may have achieved clinical "cured" [3]
.

This also means that if eligible first-line patients can receive standard maintenance therapy, then the dilemma of ovarian cancer "70% recurrence within 3 years" is likely to become a thing of the past
.

Olaparib and niraparib are also recommended by the American NCCN[4] and other guidelines for first-line maintenance treatment of ovarian cancer patients with BRCA gene mutation
.

Olaparib, niraparib and fluzoparib are recommended by China's "CSCO Guidelines for the Diagnosis and Treatment of Ovarian Cancer (2021 Edition)" for the maintenance treatment of platinum-sensitive recurrent ovarian cancer[5]
.

 The new strategy brings the dawn of life.
Under the previous treatment mode, most ovarian cancer patients had poor prognosis, and most of the patients who were fortunate to survive for a long time were also constantly fighting against recurrence during surgery and chemotherapy, and their quality of life was worrying.
A family of ovarian cancer patients poses a heavy burden
.

This breakthrough in first-line maintenance therapy is undoubtedly one of the keys to improving the quality of life of patients and realizing the chronic disease management model of ovarian cancer
.

The cost of new drug treatment is still an unbearable financial burden for many patients
.

Fortunately, through the formulation of a series of policies and the implementation of medical insurance, more patients within the scope of indications have been able to use and afford new drugs because they can use medical insurance reimbursement, so as to achieve better management and treatment of ovarian cancer throughout the process.
Results, improved prognosis and quality of life, both doctors and patients are sincerely happy to receive such news
.

BRCA mutation is actually "lucky in misfortune" Precise treatment gene detection is the key No exception
.

The most important risk factor for ovarian cancer is a family history of breast or ovarian cancer, and about 25% of ovarian cancers are caused by inherited genetic mutations
.

BRCA1 and BRCA2 gene mutations account for about 40% of familial ovarian cancers, and about 25% (6% of all ovarian/fallopian tube/peritoneal cancers) are caused by mutations in genes other than BRCA1/2 [6]
.

At present, domestic and foreign guidelines all recommend genetic testing for all ovarian cancer patients, but in fact only about 30% of patients have received relevant genetic testing [7]
.

BRCA gene testing can not only help early detection of direct female relatives or improve awareness of prevention, but more importantly, the screening results of BRCA gene mutations are also crucial for the formulation of treatment plans for patients with advanced ovarian cancer
.

It can be said that the discovery of the BRCA gene mutation led to the advent of the precise targeted drug PARP inhibitor for ovarian cancer, which achieved a major breakthrough in the treatment of ovarian cancer and made "maintenance therapy" an important part of the standard treatment for ovarian cancer
.

It is believed that with the improvement of the availability of new drugs, it will help more ovarian cancer patients benefit from innovative treatments, delay recurrence, achieve survival benefits, improve quality of life, reduce the economic burden on patients' families, and better protect the people.
The masses can be treated for their diseases, and the overall treatment level of ovarian cancer in China will be comprehensively improved
.

For more information, please click: Spring Festival Walk to the Grassroots ⑦｜Zhu Yunyang: He encountered the "skull puzzle" for the first time on duty! Experts such as Zhi Xiuyi, Tian Yantao, Guo Hongqian, etc.
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