In advanced ovarian cancer, genetic testing rates hover around 50%.1
Only 49% of patients received maintenance therapy in second line or greater therapy.2
Current rates warrant improved methods and practices to enable professionals to both identify and offer PARP-Inhibitors to appropriate patients at the right time. Please utilize instructions below to help with your patients.

Step 1: Run a report for ovarian cancer patients:

Select Electronic Medical Record (EMR) System for instructions


*This instructional guide represents a brief summary derived from NCODA practice member resources and does not substitute for the advice of your EMR provider and does not constitute or imply endorsement, recommendation, or favoring of operational considerations by NCODA. NCODA assumes no liability and does not ensure the accuracy of the information presented from the materials provided. Please consult with your EMR vendor related to this assessment initiative when implementing this assessment.

Step 2: Utilize NCODA PQI

  • Determine patient’s BRCA mutation status (consider genetic testing if not already completed)
  • Track all current or upcoming first-line platinum therapy patients with estimated completion date of their chemotherapy
  • Create a calendar reminder and maintain to mark the end of systemic therapy

Step 3:

  • Work closely and proactively with provider to determine each unique patient’s anticipated treatment plan
  • As completion date for current therapy approaches, assess treatment plan regarding maintenance therapy
  • Consider discussing treatment plan of maintenance options with provider
  • Consider monthly follow-up plan within the EMR during surveillance
  • When appropriate, ensure prescription for a PARP inhibitor is submitted
  • Consider PARP-Inhibitor utilization
TherapyOvarian Cancer Indications
Niraparib
  • For the maintenance treatment of adults with advanced epithelial ovarian, fallopian tube or primary peritoneal cancer who are in either complete or partial clinical response to first line platinum-based chemotherapy
  • Maintenance treatment of adults with recurrent epithelial ovarian, fallopian tube or primary peritoneal cancer who are in either complete or partial clinical response to platinum-based chemotherapy
  • Treatment of adult patients with advanced ovarian, fallopian tube, or primary peritoneal cancer who have been treated in the past with 3 or more types of chemotherapy regimens and is associated with a positive homologous recombination deficiency (HRD) positive status defined by either
    • deleterious or suspected deleterious BRCA mutation or
    • genomic instability and who have progressed more than 6 months after response to the last platinum-based chemotherapy.
Rucaparib
  • For the maintenance treatment of adult patients with recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer who are in a complete or partial response to platinum-based chemotherapy.
  • For the treatment of adult patients with a deleterious BRCA mutation (germline and/or somatic)-associated epithelial ovarian, fallopian tube, or primary peritoneal cancer who have been treated with two or more chemotherapies.
Olaparib
  • For the maintenance treatment of adult patients with deleterious or suspected deleterious germline or somatic BRCA-mutated advanced epithelial ovarian, fallopian tube or primary peritoneal cancer who are in complete or partial response to first-line platinum-based chemotherapy
  • In combination with bevacizumab for the maintenance treatment of adult patients with advanced epithelial ovarian, fallopian tube or primary peritoneal cancer who are in complete or partial response to first-line platinum-based chemotherapy and whose cancer is associated with homologous recombination deficiency (HRD)-positive status defined by either
    • deleterious or suspected deleterious BRCA mutation, and/or
    • genomic instability
  • For the maintenance treatment of adult patients with recurrent epithelial ovarian, fallopian tube or primary peritoneal cancer who are in complete or partial response to platinum-based chemotherapy
  • For the treatment of adult patients with deleterious or suspected deleterious germline BRCA-mutate (gBRCAm) advanced ovarian cancer who have been treated with three or more prior lines of chemotherapy

Step 4:

1. Randall LM, Aydin E, Louie-Gao M, Hazard S, Westin SN. A retrospective analysis of real-world tumor BRCA (tBRCA) testing trends in ovarian cancer before and after PARP inhibitor approvals. Presented at the 17th Biennial Meeting of the International Gynecologic Cancer Society; Kyoto, Japan: 2018.

2. Garofalo D, Verma-Kurvari S, Aydin E, et al. Real world data analysis of ovarian cancer maintenance utilization among maintenance eligible patients. Presented at the American Society of Clinical Oncology Annual Congress; Chicago, IL: 2019.