Treatment algorithm in patients with ovarian cancer.

Most ovarian cancer patients are diagnosed only at advanced stages when survival outcomes are worse, andwhen therapeutic decisions might prove challenging. The fundamental treatment for women with ovarian cancerincludes debulking surgery whenever possible and appropriate systemic therapy (chemotherapy, targeted andantiangiogenic agents). In the last few years, knowledge about histological and molecular characteristics of ovariancancer subtypes and stages has increased considerably. This has enabled the development and improvement ofseveral options for the diagnosis and treatment of ovarian cancer in a patient-tailored approach. Accordingly,therapeutic decisions are guided by the characteristics of the patient and the tumour, especially the molecularfeatures of the cancer subtype and disease stage. Particularly relevant are the advances in early genetic testing ofgermline and somatic mutations involved in DNA repair, and the clinical development of targeted agents. In orderto implement the best individual medical strategies, in this article, we present an algorithm of treatment options,including recently developed targeted agents, for primary and recurrent ovarian cancer patients in Belgium.

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Disclosure statement: Dr. Denys reports consulting fees (advisory role) paid to her institution by Pfizer, Roche, PharmaMar, AstraZeneca, Eli Lilly, Novartis, Amgen, Tesaro; grants from Research Funding institutional Roche; and other fees (travel, accommodations, expenses) by Pfizer, Roche, PharmaMar, Teva, AstraZeneca; all of these outside the submitted work. Dr. Gennigens reports personal fees for advisory boards from BMS, Pfizer (including travel), MSD, and Ipsen (including travel); all of these outside the submitted work. Dr. Vergote reports personal fees for consulting (paid to his university) from Deciphera Pharmaceuticals, Verastem Oncology, MSD Belgium, Roche NV, Genmab A/S - Genmab B.V. - Genmab US, F. Hoffman-La Roche Ltd, Pharmamar-DoctaforumServicios SL, Millennium Pharmaceuticals, Clovis Oncology, AstraZeneca NV, AstraZeneca UK Ltd, AstraZeneca Belux, Tesaro Inc.,Tesaro Bio GmbH, Oncoinvent AS, Immunogen Inc, Sotio a.s., Amgen Europe, Carrick Therapeutics, Debiopharm International SA, GSK GlaxoSmithKline Pharmaceuticals, Medical University of Vienna, and Octimet Oncology NV. He also reports grants from Amgen and Roche; other fees (contracted research) from Oncoinvent AS and Genmab; and fees to cover accommodation and travel expenses from Takeda Oncology, Pharma Mar, Genmab, Roche, AstraZeneca, Tesaro, Clovis, and Immunogen. All the Potential Conflicts of Interest reported by Dr. Vergote are outside the submitted work. Dr. Vuylsteke reports advisory board fees and travel grants from AstraZeneca, Roche, MSD, BMS, and Pfizer. Dr. Van de Vijver, Dr. Baurain and Dr. Kerger have nothing to declare. Dr. De Greve reports personal fees as a member of the AstraZeneca Foundation board and institutional clinical trial grants for IIS trials from Roche and AstraZeneca.