Gynae Oncology Trials Update Dr Rebecca Bowen Consultant Medical Oncologist

Ovary 1st line ICON8B – Bath, Bristol, Cheltenham, WSM Platinum Sensitive Relapse ICON9 – to open in all centres soon Platinum resistant OCTOPUS – currently suspended (all) Clear Cell NiCCC – Bristol BRCA OCTOPUS – Bath (shortly to be amended to non- BRCA too – PARPi/ Cedirinib in platinum resistance) Many women treated for breast and some treated for gynaecological cancers require hormone treatments which cause significant and sometimes intolerable side effects which have a major impact on quality of life and can affect compliance and treatment efficacy and prognosis. Other women treated for breast, gynaecological and other malignancies have a medical or surgical-induced early menopause and suffer in similar ways as well as being at risk of the longer term health issues of an early menopause. NICE guidelines for Menopause management published in 2015 (ng23) recommend that care is “provided by a healthcare professional with expertise in menopause (for example, women with breast cancer should have access to a specialist menopause clinic or professional but often receive treatment for menopause from their oncologist who may not have the appropriate training)”. They also recommend the provision of “dedicated menopause support” by setting up multispecialist menopause clinics, “jointly led by a nurse consultant and a consultant ensuring that when a member of staff is unavailable the clinic may still run”. The majority of these patients are no longer reviewed routinely and are discharged back to the community following their immediate cancer treatment. Problems occurring on treatment may be referred back to the MultiDisciplinary Team meeting where decisions regarding a patients treatment are made without adequate representation from the patient.

Other MROC – MRI in ovarian staging – Cheltenham RANGO – rare Gynae cancers registry – all HORIZONS – quality of life study post treatment ovary, endometrial, cervix, vulva - Bath Many women treated for breast and some treated for gynaecological cancers require hormone treatments which cause significant and sometimes intolerable side effects which have a major impact on quality of life and can affect compliance and treatment efficacy and prognosis. Other women treated for breast, gynaecological and other malignancies have a medical or surgical-induced early menopause and suffer in similar ways as well as being at risk of the longer term health issues of an early menopause. NICE guidelines for Menopause management published in 2015 (ng23) recommend that care is “provided by a healthcare professional with expertise in menopause (for example, women with breast cancer should have access to a specialist menopause clinic or professional but often receive treatment for menopause from their oncologist who may not have the appropriate training)”. They also recommend the provision of “dedicated menopause support” by setting up multispecialist menopause clinics, “jointly led by a nurse consultant and a consultant ensuring that when a member of staff is unavailable the clinic may still run”. The majority of these patients are no longer reviewed routinely and are discharged back to the community following their immediate cancer treatment. Problems occurring on treatment may be referred back to the MultiDisciplinary Team meeting where decisions regarding a patients treatment are made without adequate representation from the patient.

Endometrial STATEC – adjuvant therapy selection – Bristol, Bath & Cheltenham in set-up DICE – dual TORC1/2i, Pi3Ki, weekly taxol combinations. 2nd line on. Bristol COPELIA – awaited – all sites Many women treated for breast and some treated for gynaecological cancers require hormone treatments which cause significant and sometimes intolerable side effects which have a major impact on quality of life and can affect compliance and treatment efficacy and prognosis. Other women treated for breast, gynaecological and other malignancies have a medical or surgical-induced early menopause and suffer in similar ways as well as being at risk of the longer term health issues of an early menopause. NICE guidelines for Menopause management published in 2015 (ng23) recommend that care is “provided by a healthcare professional with expertise in menopause (for example, women with breast cancer should have access to a specialist menopause clinic or professional but often receive treatment for menopause from their oncologist who may not have the appropriate training)”. They also recommend the provision of “dedicated menopause support” by setting up multispecialist menopause clinics, “jointly led by a nurse consultant and a consultant ensuring that when a member of staff is unavailable the clinic may still run”. The majority of these patients are no longer reviewed routinely and are discharged back to the community following their immediate cancer treatment. Problems occurring on treatment may be referred back to the MultiDisciplinary Team meeting where decisions regarding a patients treatment are made without adequate representation from the patient.

Cervix Interlace – locally advanced. Dose dense chemo. Cheltenham IOVANCE – TILS/ Il-2 study in metastatic cervix ca. Bristol COPELIA – maintenance PARPi/ Cedirinib. Metastatic. Awaited in all sites Many women treated for breast and some treated for gynaecological cancers require hormone treatments which cause significant and sometimes intolerable side effects which have a major impact on quality of life and can affect compliance and treatment efficacy and prognosis. Other women treated for breast, gynaecological and other malignancies have a medical or surgical-induced early menopause and suffer in similar ways as well as being at risk of the longer term health issues of an early menopause. NICE guidelines for Menopause management published in 2015 (ng23) recommend that care is “provided by a healthcare professional with expertise in menopause (for example, women with breast cancer should have access to a specialist menopause clinic or professional but often receive treatment for menopause from their oncologist who may not have the appropriate training)”. They also recommend the provision of “dedicated menopause support” by setting up multispecialist menopause clinics, “jointly led by a nurse consultant and a consultant ensuring that when a member of staff is unavailable the clinic may still run”. The majority of these patients are no longer reviewed routinely and are discharged back to the community following their immediate cancer treatment. Problems occurring on treatment may be referred back to the MultiDisciplinary Team meeting where decisions regarding a patients treatment are made without adequate representation from the patient.

Many women treated for breast and some treated for gynaecological cancers require hormone treatments which cause significant and sometimes intolerable side effects which have a major impact on quality of life and can affect compliance and treatment efficacy and prognosis. Other women treated for breast, gynaecological and other malignancies have a medical or surgical-induced early menopause and suffer in similar ways as well as being at risk of the longer term health issues of an early menopause. NICE guidelines for Menopause management published in 2015 (ng23) recommend that care is “provided by a healthcare professional with expertise in menopause (for example, women with breast cancer should have access to a specialist menopause clinic or professional but often receive treatment for menopause from their oncologist who may not have the appropriate training)”. They also recommend the provision of “dedicated menopause support” by setting up multispecialist menopause clinics, “jointly led by a nurse consultant and a consultant ensuring that when a member of staff is unavailable the clinic may still run”. The majority of these patients are no longer reviewed routinely and are discharged back to the community following their immediate cancer treatment. Problems occurring on treatment may be referred back to the MultiDisciplinary Team meeting where decisions regarding a patients treatment are made without adequate representation from the patient. 5th by LCRN according to data obtained by ovarian cancer charities – improved from last year