2014 Ovarian Cancer National Conference: Launching the Women's Cancer Moonshot
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The Women's Cancer Moonshot initiative aims to leverage advanced technology and collaborative networks to improve outcomes for ovarian and breast cancer. Key projects include genetic testing for high-grade serous ovarian carcinoma and triple-negative breast cancer, personalized surgical therapy, and novel clinical trial development to enhance patient care. The initiative involves collaboration among leading cancer research organizations, focusing on personalized treatment approaches and community engagement.
2014 Ovarian Cancer National Conference: Launching the Women's Cancer Moonshot
- 1. Launching the Women’s Cancer Moonshot Anil K. Sood, M.D., Professor Vice Chair, Translational Research Departments of Gynecologic Oncology and Cancer Biology Co-Director, Center for RNAi and Non-Coding RNA Director, Blanton-Davis Ovarian Cancer Research Program
- 2. Concept: Make the Impossible…Possible John F. Kennedy Moon Speech, Rice Stadium September 12, 1962
- 3. Strategic Initiative Cancer Moon Shot Program Can we systematically harness the full potential of today’s technology, major conceptual advances and our critical mass and collaborative networks to more rapidly drive progress in the field?
- 4. Why a Combined Ovarian and Breast Cancer Moonshot? • Medical Need and Impact • Deep knowledge and molecular characterization • Common predisposition factors Common concepts for risk, prevention, screening and survivorship • Molecular, biological and clinical commonalities • Cross pollination
- 5. Flagship Projects: THE START •Will have immediate impact on patient outcomes •Can be implemented without “new knowledge” •Broadly applicable across disease •Engage the community: Faculty, patients and outreach •Efficiencies offered by Moon Shot Platforms
- 6. Germline BRCA-1 and -2 testing (>10% will be positive) Active Outreach Screening Prevention Offer genetic testing to all patients with HGSOC or TNBC Flagship project 1a: Impacting the Family
- 7. Goal: 80% decrease in deaths in family members over 5 years Flagship project 1a: Impacting the Family
- 8. 20-50% of patients will have a defect in the function of BRCA1 or BRCA2 PARP-inhibitor based therapy Offer genetic testing to all patients with HGSOC or TNBC Flagship project 1b: Impacting the Patient
- 9. Flagship Project 2: Personalizing Surgical Therapy Impact of residual disease: Overall survival Dubois et al, Cancer, 2009: Mar 15; 115(6): 1234-44
- 10. Opportunity For Quality Improvement: Personalized Surgical Therapy Women w/ suspected ovarian cancer Primary Assessment Intraoperative agreement Laparoscopy: Validated score R0 not feasible Neo-adjuvant chemotherapy R0 feasible Primary tumor reductive surgery Tissue
- 11. Primary cytoreduction 20% 87% (n=50) NACT → Interval cytoreduction 60% 76% (n=14) Surgical Outcomes (R0 Rates) since Implementation of FP2A Pre- implementation Post- implementation *Major effort focused on R0 resection included education, clinical retreats, and engaging other specialties *Compliance is >95%
- 12. NEXT STEPS • Development of novel clinical trials – Window of opportunity trials – Novel biologic combinations plus standard neoadjuvant chemotherapy • Comparative effectiveness assessment • Expansion into other institutions – Sister Institution Network
- 13. NEW MOONSHOT PROJECTS-FP2B OVARIAN FlagshipProject2 LSC Score <8 FP2b Phase 0 “Window” trials 1-2 wks Single Agents “POSITION” Trial Debulking Tissue acquisition Novel therapy vs. Std therapy Tissue acquisition e.g., BMN-673 Score >8 FP2b Phase Ib-2 Treatment Trials NACT Pac/Carbo + novel Debulking Adjuvant Pac/Carbo + novel Tissue acquisition e.g., SPD535
- 14. PROJECT 2A/B – AGENTS • PARPi: BMN-673, olaparib, others • PI3K pathway: BKM120, AZD2014 • Angiogenesis: Dll4 (demcizumab), TAMs (zoledronic acid, AC708) • Immune: PD-1 (MK-3475) • P53: MK-1775, COTI-2 • Platelets: SPD535 • Others: Prolanta (PrL), KPT-330
- 15. Other Deliverables • Translational biology • P53 based approaches – synthetic lethality • Adaptive changes to therapy • Rational combination therapy (e.g., new combinations of kinase inhibitors, synergistic combinations with PARP inhibitors) • Immune modulation/inflammation as therapy targets • Mechanisms by which stress hormones affect tumor growth • Survivorship • Identify and validate predictors of long-term survival • Predictors of toxicity
- 16. • Collaborating organizations: – M.D. Anderson – Memorial Sloan Kettering – Cedars Sinai Medical Center – Univ. of Iowa – Univ. of Oklahoma – OCNA – Clearity Foundation – Nine Girls Ask Consortium to Study Long-Term Survivors of Ovarian Cancer (DOD) • Projects: 1. Molecular predictors 2. Biobehavioral, social, and demographic features 3. Clinical and surgical factors
- 17. Women’s Cancer Moonshot Team