Recommendation 7
Studies consistently show that women who have access to expert care conducted according to evidence-based standards respond better to treatment and live significantly longer. But the distribution of this care is unequal; older women and those with comorbidities; women of color; lower socioeconomic status; and who live in rural areas are much less likely to receive such care. These disparities must be reduced.
“Our efforts here will require adopting innovative models of care, which may include telemedicine,” and other ways of bringing high-quality care to underserved women, Dr. Karlan said.
Recommendation 8
Little is known about why some ovarian tumors become treatment resistant. As subtypes become categorized, this knowledge gap may become even greater. A comprehensive biological categorization of tumor subtypes will help pave the way for targeted, personalized treatment strategies with both existing and yet-to-be developed agents.
“We also need more research on the optimal timing of surgeries and the impact of the multiple subsequent surgeries that most women undergo,” Dr. Karlan said.
Recommendation 9
In addition to more effective therapies, more varied therapies are also needed. These could be both pharmacologic and nonpharmacologic. Their development requires an organized and effective clinical trial system and an improved understanding of tumors’ basic biology.
Recommendation 10
Supportive care is not just necessary at the end of life. Physical and psychosocial factors are important determinants of treatment success as well as quality of life, from diagnosis through treatment and into terminal stages. Optimizing these factors and removing barriers to improving them can lead to benefits all along this spectrum, said Ms. Scroggins.
“We need research not only into improving how we can survive, but how well we survive,” she said. “It’s not an either-or proposition. Both are important.”
Recommendation 11
Knowledge gained is helpful only if that knowledge is shared. Learning how to disseminate new findings is the only way to ensure that patients benefit from them. “We need to examine what keeps us from fully implementing current standards of care, and to investigate multiple modalities and innovative pathways to communicate new understandings,” Ms. Scroggins said.
The document was created under the auspices of the National Academy of Sciences and supported by federal funds. None of the committee members declared any financial conflicts.