KP Research Radio: A promising treatment for ovarian cancer

5 Questions for…Dr. Michael A. Bookman, co-leader of a clinical trial that could provide an important new treatment option for women with advanced gynecological cancers.

Ovarian cancer has been called the “silent killer,” because it often goes undetected until reaching an advanced stage. In spite of effective surgery and chemotherapy, more than three-quarters of patients will have a recurrence within 3 years. For more than 3 decades, oncologists have been searching for new ways to enhance the effectiveness of currently available treatments.

Kaiser Permanente has been participating in a clinical trial to evaluate a promising new treatment for advanced ovarian cancer. Veliparib is one of a new class of a drugs called PARP inhibitors, which can prevent cancer cells from repairing damage to their DNA caused by mutations or chemotherapy.

In this international clinical trial with 1,140 patients, the addition of veliparib halted the progression of serious ovarian cancer for 6 months to a year. The investigators, co-led by Kaiser Permanente oncologists Michael A. Bookman, MD and Ramey Littell, MD, published these important findings in New England Journal of Medicine (“Veliparib with First-Line Chemotherapy and as Maintenance Therapy in Ovarian Cancer,” by Coleman et al.) and presented their results recently to the European Society of Medical Oncology in Barcelona, Spain.

Dr. Bookman joined Kaiser Permanente Northern California in 2017 as medical director of gynecologic oncology therapeutics. Trained at Harvard Medical School, Dr. Bookman has more than 3 decades of experience treating women with gynecologic cancers in national and international clinical research organizations, including Fox Chase Cancer Center in Philadelphia and the University of Arizona. We asked him 5 questions:

What was the goal of the veliparib clinical trial?

Our goal was to offer a PARP inhibitor to a broader group of patients in the front-line setting, to maximize the benefit from chemotherapy and improve overall survival for what has largely been a non-curable disease.

What did you learn from this research?

We were able to show that remission could be extended significantly for all groups of patients, regardless of the cancer’s molecular or clinical features, thereby making a PARP inhibitor available to a much wider range of patients than previously considered. This is potentially practice-changing for our patients. We’ve not yet shown that veliparib improves overall survival, but we believe there is a significant benefit to our patients from progression-free survival, giving them more time without having to deal with problems related to their cancer. We have also provided support to study new combinations of PARP inhibitors with other agents, to hopefully achieve even better results.

Why did you come to Kaiser Permanente to practice medical oncology?

I came to Kaiser Permanente to develop a stronger, more diverse clinical research program in gynecologic oncology, building on a strong multidisciplinary team. Kaiser Permanente has a lot of appeal because of its ability to focus on the needs and expectations of our patients. We are able to do things here that are much more aligned with current knowledge and put them together in a way that provides benefit for our patients.

What led you to specialize in medical oncology?

In fact, when I was an undergraduate my major focus of research was with homing pigeons and how they navigate. If you work with animals and try to understand how they perceive the world, it changes how you view the world. I probably would have been happy doing more research in that area, but I also thought I could apply some of that approach to medical biology, and cancer in particular.

How do you like to spend your free time?

The things that I enjoy the most are hiking, astronomy, and photography. I also appreciate the opportunity to travel and build international collaborations. Being involved with clinical studies opens up many new horizons.

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