Some highlights of the chat are provided below.
T1: Whether or not a woman should have a second surgery for ovarian cancer continues to be debated. What does the most recent research suggest and what do women need to consider?
- Two presentations at #ASCO20 - Complete Cytoreductive surgery is crucial in improving outcomes (Desktop III and SOC Studies) Patients with surgery and incomplete resection had worse outcomes (median 28.8 months). https://meetinglibrary.asco.org/record/185438/abstract
- Three trials have looked at this question all with slightly different patient enrollment in different environments. To distill the results the decision for secondary cytoreduction for women with #ovariancancer comes down to careful patient selection.
T2: PARP inhibitors took center stage again in the care of women with ovarian cancer. With one study reaching its goal and one that did not, what do women need to know?
- The final overall survival (OS) results from SOLO2/ENGOT-ov21 maintenance olaparib study showed an improvement of 12.9 months in median OS vs placebo. 1/2
- These patients all had germline BRCA mutations and only 38% of the patients receiving placebo went on to receive a parp later. This leaves HUGE questions about the sequencing and timing of parp inhibitors for women with #ovariancancer.
- 2/2 A phase III PARP study compared olaparib to cediranib /olaparib to standard platinum chemo (SOC) in recurrent platinum-sensitive #ovca . Cediranib /olaparib demonstrated similar activity to SOC in relapsed platinum -sensitive ovca but did not meet the primary endpoint of improved progression free survival.
In other news from ASCO, the #gyncsm community had an online #ASCO2020 abstract: Abstract e14113 Social media and gynecologic cancers: The impact of Twitter https://meetinglibrary.asco.org/record/187383/abstract .
Note: In the coming months, we’ll have the chance to discuss more gyn cancer research as we chat about endometrial cancer (Aug 12) and rare ovarian cancers (Sept 9).
Moving on to the Survivors Advising Scientists Educational Program (SASEP) .
T3: What is the "Survivors Advising Scientists Educational Program”? What led to its development?
Survivors Advising Scientists is a program initiative I [Kimberly Richardson] developed while participating in NCCS ELEVATE Ambassador Program last year.
- The topics are designed to introduce important scientific concepts so cancer research advocates and patients can participate in scientific dialogue and important decision making. The modules cover the following:
- 1.Scientific Hypotheses 2.Components of a Hypothesis 3.Exp. Variables 4.Confounding Variables 5. Exp. Errors 6.Stat Significance 7.Types of Clinical Studies 8. Bias and Randomization 9. Read Scientific Poster
- Additionally, we are currently looking for more content ideas. Please email us at SASEP@UIC.edu for any suggestions. You can access the videos here: https://sasep.typeform.com/to/kyOKes
T5: Let’s talk about the module on “How to Read a Scientific Poster”. What are the main points patients/advocates should consider when reading a scientific poster presented at an annual meeting like ASCO or SGO?
- the direction in which sci. posters are typically read is from top to bottom, left to right. Some conferences will have requirements that all research presenters must follow. For ASCO’s conference, all main findings must be placed in the middle of poster.
- The next and one of the most important pieces of a poster is the hypothesis which is usually found in the top left corner. The hypothesis is the an educated guess the researchers use to try to answer a scientific question.
- Some of the more interesting parts of a poster are the results or data, which are usually found in the center column/s of a poster. This section shows readers what information the researchers gathered/learned as a result of their experiments.
- If you’re overwhelmed reading a poster, another good place to look is the conclusions section, usually found in the bottom right corner (for ASCO, in the center column). This area summarizes the results of the study and may point out what is left to do.
T6: This poster from #ASCO2020 reports on the low rate of BRCA testing for patients with ovarian cancer.
Using this as an example, can you walk us through how an advocate/patient/survivor could read and understand it?
- Some posters may be intimidating with jargon and lots of numbers/data. But following simple steps can help break concepts down so you can begin to understand the “big picture” of the study.
- Title: the title of this poster makes it clear the topic is about the low rate of testing for BRCA1/2 mutations in ovarian cancer patients, but we need to read a little more to get more information.
- In this poster, the next big section that catches your eye is the paragraph in the center. You would most likely read this summary first to get the “take home” message, then continue to read the poster normally.
- Background: this section gives a brief introduction to ovarian cancer and the two genes of interest. Here we learn these genes increase the risk of likelihood of developing ovarian cancer.
- Methods: this section has a flow chart explaining the process of data collection. This is not the most important part if you’re reading to find results, but it can provide a lot of information about how well the study was designed.
- Method 2: You’ll also see a demographics table on the far right of the poster. This information could be considered part of the methods, since it is describing the body of patients included in the study.
- Results: this section is in the bottom left - which is a little unusual but looks like it was done for spacing purposes. There is also a large results box in the middle of the poster - designed to draw attention to the “take home” message quickly.
- Discussion: this section is describing the results or conclusions of the research. This is also sometimes called “conclusions”, but it is very important because it shares results and puts them into context.
- Discussion 2: This poster shows that only a very small percentage of patients with ovarian cancer had a documented test for BRCA1/2 mutation, even though guidance suggests that all patients should receive this test.
T7: Here is another poster from #ASCO2020 discussing early-line treatment for endometrial cancer.
Using the tips from your module, what are the key points to learn from this poster?
- Title tells us that a drug combination (Lenvatinib + Pembrolizumab) is being tested as early treatment for endometrial cancer. If these therapies r unfamiliar to you, you can ask the presenter for more information or look them up on google scholar or pubmed.
- The goal of the study is to evaluate the safety and efficacy of this drug combination. They use the word “post hoc” analysis, which means the clinical trial has already been performed and now they are analyzing the data.
- Post-hoc means they are not stating a hypothesis as they would if they were currently designing the clinical trial (eg, combination therapy will lead to increased overall survival compared to standard chemotherapy in patients with endometrial cancer).
- Methods: Here we see the researchers are analyzing data from KEYNOTE clinical trial (NCT02501096). The “overall population” is the larger group of patients with endometrial cancer. Subgroup 1 is small subset of those patients who haven’t received much treatment
- Methods 2: This study is using post-hoc (after trial completion) analysis to compare the effect of the treatment in subgroup 1 and the overall population to determine if it would work as an early-line treatment.
- Results: Efficacy is the key word for this poster (bottom left corner) - did the drug combination being tested work? U can see that 36% of the overall population had a response to the treatment - or the treatment worked to improve disease state in 36% of patients
- Safety: Since this poster is about a clinical trial, this section is important to include information for both clinicians and patients. The safety profile of the subgroup population matches the overall population and no new safety concerns were found.
- Conclusions: The conclusions are found right in the middle in large font - designed so that they are easy to find.
- Conclusions 2: The conclusion is that the treatment (lenvatinib + pembrolizumab) seems to work in this study for this population (advanced endometrial cancer that is not MSI-H or dMMR) as a method of early-line treatment.And 26% of patients in subgroup 1 responded.
We were honored to feature one of these great new SASEP modules during this chat. Thank you Kimberly Richardson, Benjamin Gordon, Tova Bergsten and Casey Blaha for taking the time to join us and share such helpful information with the #gyncsm community. You may find the modules at https://sasep.typeform.com/to/kyOKes.
Save the date for our next #gyncsm chat Wed Aug 12 at 9pmET on Endometrial Cancer - Risks, Symptoms, Treatment.
See you then - Stay safe.