Gynaecological cancer: Where are we now?

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Published: 21 Mar 2019
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Dr Nelleke Ottevanger - Radboud University Medical Center, Nijmegen, Netherlands

Dr Nelleke Ottevanger speaks to ecancer at the 2019 EORTC Groups Annual Meeting about the discussions that took place in the EORTC's Gynecological Cancer Group meeting.

Dr Ottevanger highlights the competition that surrounds gynaecological research currently and the difficulty to conduct investigator initiative trials.

She also mentions the development of a novel progesterone inhibitor for endometrial cancer and low-grade ovarian cancer.

For the future, Dr Ottevanger and her group would like to focus on the maintenance treatment of hormone receptor-positive endometrial and ovarian cancer, in combination with a CDK4/6 inhibitor. In addition to this, the group would also like to develop a PIK3-CA inhibitor for these types of cancer.

We discussed the trials that are ongoing and we discussed two new proposals with new drugs for endometrial and ovarian cancer. The problem in gynaecological cancer is that we have now many country-oriented groups and the field is very competitive which means that all the big pharma companies want to do their industry trials and there’s not too much room for investigator initiated trials. So we are now looking for small companies who are not in the big pharma world who want to cooperate with us and we now have one company, that is Context Therapeutics, and they would like to develop with us a new programme for their progesterone inhibitor in endometrial cancer and low grade serous ovarian cancer.

What further developments would you like to see in the treatment of these cancers?

What we would like to do is more focus on the treatment of hormonal receptor positive endometrial and ovarian cancer in a way of maintenance treatment, for example in combination with CDK4/6 inhibitor, because we think that that would be a very important step forward if you compare it, for example, with breast cancer where it’s now registered. But for ovarian cancer and endometrial cancer it’s very difficult to get a CDK4/6 inhibitor on board, together with other hormonal treatments.

The other thing we are looking for is a PIK3CA inhibitor because we know that gynaecological cancers have a lot of disturbances and aberrations in their PIK3CA pathways. That could be another way of better targeting of the gynaecological cancers so that’s the other thing we are exploring.

What are the goals for the group over the coming few years?

The big goal is, of course, to have a large umbrella trial with a lot of drugs but the problem is that the competing field is so difficult that the large companies are, at the moment, not interested in gynaecological cancer from EORTC.