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Review
. 2024 May;35(3):e87.
doi: 10.3802/jgo.2024.35.e87. Epub 2024 Apr 3.

Current treatment strategies for ovarian cancer in the East Asian Gynecologic Oncology Trial Group (EAGOT)

Yusuke Kobayashi  1 , Muneaki Shimada  2 , Masato Tamate  3 , Hyun Woong Cho  4 , Jun Zhu  5 , Hung-Hsueh Chou  6   7 , Hiroaki Kajiyama  8 , Aikou Okamoto  9 , Daisuke Aoki  10 , Sokbom Kang  11 , Jeong-Won Lee  12 , Jae-Weon Kim  13 , Jae-Hoon Kim  14 , Zhongqiu Lin  15 , Jihong Liu  16 , Xiaohua Wu  17 , Hung-Cheng Lai  18 , Ting-Chang Chang  6   19 , Chyong-Huey Lai  19 , Yong Man Kim  20 , Takayuki Enomoto  21
Affiliations
Review

Current treatment strategies for ovarian cancer in the East Asian Gynecologic Oncology Trial Group (EAGOT)

Yusuke Kobayashi et al. J Gynecol Oncol. 2024 May.

Abstract

Ovarian cancer, notable for its severe prognosis among gynecologic cancers, has seen substantial progress in treatment approaches recently. Enhanced protocols in chemotherapy and the introduction of poly (ADP-ribose) polymerase (PARP) inhibitors for maintenance therapy have markedly improved outcomes for patients with specific genetic profiles, such as those positive for BRCA mutations or exhibiting homologous recombination deficiency (HRD). Additionally, the method of intraperitoneal chemotherapy administration has emerged as a valuable alternative to traditional transvenous routes, showing promise for wider clinical adoption. The field of surgery has also evolved, with increasing exploration into the benefits and feasibility of laparoscopic methods over more invasive traditional surgeries, aiming for complete tumor removal but with reduced patient impact. The hereditary nature of ovarian cancer underscores the importance of genetic testing, which has become integral in tailoring treatment strategies, particularly in determining suitability for PARP inhibitors. The formation of the East Asian Gynecologic Oncology Trial Group (EAGOT) aims to optimize treatment across Japan, Korea, China, and Taiwan. The ovarian cancer committee of EAGOT shared the current policies, focusing on 5 topics: 1) strategies for maintenance therapy after initial surgery and chemotherapy, 2) drug regimens for platinum-sensitive and platinum-resistant recurrence, 3) intraperitoneal chemotherapy, 4) laparoscopic surgery as an alternative to laparotomy, and 5) current status of genetic testing (BRCA, HRD, and panel tests) for ovarian cancer and its prospects. EAGOT's multi-national trials aim to harmonize these evolving treatment strategies, ensuring that the latest and most effective protocols are accessible across the region, thereby significantly impacting patient outcomes in East Asia.

Keywords: East Asian Gynecologic Oncology Trial Group; Genetic Testing; Intraperitoneal Chemotherapy; Laparoscopic Surgery; Ovarian Cancer; PARP Inhibitors.

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Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1. Strategies for maintenance therapy following initial surgery and chemotherapy in Japan.
HRD, homologous recombination defect.
Fig. 2
Fig. 2. Strategies for maintenance therapy following initial surgery and chemotherapy in Korea.
BEV, bevacizumab; BRCAm, mutated BRCA; BRCAwt, wild-type BRCA; CR, complete response; HRD, homologous recombination defect; HRP, homologous recombination proficient; IDS, interval debulking surgery; PDS, primary debulking surgery; PR, partial response.
Fig. 3
Fig. 3. Strategies for maintenance therapy following initial surgery and chemotherapy in China.
BRCAm, mutated BRCA; CR, complete response; CT, chemotherapy; HRD, homologous recombination defect; PR, partial response.
Fig. 4
Fig. 4. Strategies for maintenance therapy following initial surgery and chemotherapy in Taiwan.
BRCAm, mutated BRCA; BRCAwt, wild-type BRCA; HRD, homologous recombination defect.
Fig. 5
Fig. 5. Treatment algorithm for recurrent ovarian cancer in Japan.
CR, complete response; CT, computed tomography; dMMR, deficient mismatch repair; MIS, minimally invasive surgery; MRI, magnetic resonance imaging; PR, partial response; PS, performance status; SDS, secondary debulking surgery; TMB-H, tumor mutational burden-high.
Fig. 6
Fig. 6. Treatment algorithm for recurrent ovarian cancer in Korea.
BEV, bevacizumab; BRCAm, mutated BRCA; BRCAwt, wild-type BRCA; HRD, homologous recombination defect; HRP, homologous recombination proficient; PARP, poly (ADP-ribose) polymerase.
Fig. 7
Fig. 7. Treatment algorithm for recurrent ovarian cancer in China.
CT, chemotherapy; HRD, homologous recombination defect; PARP, poly (ADP-ribose) polymerase.
Fig. 8
Fig. 8. Treatment algorithm for recurrent ovarian cancer in Taiwan.
PARPi, poly (ADP-ribose) polymerase inhibitors.
See this image and copyright information in PMC

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