Challenges and Opportunities for Transformative Therapeutic Development for Ovarian Cancer
Forum Chairs
Forum Description
Ovarian cancer is one of the most aggressive cancers and a major cause of cancer morbidity and mortality in women. Poor outcomes relate, in part, to lack of adequate screening procedures, late stage at initial diagnosis, intrinsic or acquired drug resistance, and the propensity to disseminate widely intra-peritoneally. These traits render ovarian cancer one of the most challenging diseases to manage, with cytoreductive surgery and combination platinum-based chemotherapy having remained the mainstays of treatment. However, in the past few years, the completing of the TCGA analysis led to a new molecular classification of ovarian tumors and novel therapeutic strategies advanced to the forefront. Although there are now more than 280,000 ovarian cancer survivors in the United States, long-term survival in late-stage disease has improved little over the last four decades.
Forum Summary
Ovarian cancer is the most lethal malignancy in gynecologic cancers. Although it is the 11th most common cancer in women, this cancer remains the 5th leading cause of death in women. Although most women respond initially to platinum-containing chemotherapy, 80% of women will relapse, become treatment resistance, and will die from this disease. These clinical outcomes led to the main theme of the Forbeck Forum “Challenges and Opportunities for Transformative Therapeutic Development for Ovarian Cancer” on March 11-12, 2022. At this forum, transformative ways to target treatment resistance to PARPi resistance, immunotherapy, and chemotherapy (carboplatin, cisplatin, gemcitabine, and paclitaxel) were presented by known leaders in the field with the ultimate goal of improving outcomes of ovarian cancer patients.
To address resistance, we discussed key potential targets including:
- enhancing the immune system through a specific pathway called cGAS-STING (i.e., “innate” immunity) to recognize and eradicate ovarian tumor cells
- epigenetics (not genetics), including DNA methylation and proteins that package DNA called histones, and bringing new epigenetic therapies into the ovarian cancer (OC) clinic
- targeting chemotherapy-induced cancer stem cells (CSCs), the small population of highly drug resistant cells that survive after chemotherapy, and ways to prevent enrichment of OCSCs
- employing immunotherapy combined with other therapeutics, including PARP inhibitors (PARPi) and epigenetic drugs (to “prime” the immune system), and the potential of starting these therapeutic approaches earlier during the course of OC treatment
- inhibiting DNA methylation to reduce evasion of OC cells by the immune system, using DNA methylation inhibitors to activate otherwise “repressed” elements that can cause immune signaling and enhance the innate immune system against ovarian tumor cells
- specific targets on the surface of OC cells (membrane receptors) and new drugs for these targets
- identifying how the origin of OC (ovarian surface epithelium vs fallopian tube epithelium cancer) may inform development of therapies
- biomarkers for response to PARPi, mechanisms underlying resistance and overcoming resistance to PARPi and new clinical trials designed to expand the use of PARPi
- novel mouse models that harbor common genetic changes found in human OC
- therapeutic vulnerabilities based on metabolism of OC cells and the tumor microenvironment
This forum was unique with the expertise of the participants in epigenetics, DNA repair, immunology, pathology, CRISPR (gene editing) technology, transposable elements and senescence. Additional expertise included basic scientists, translational scientists, mouse model system experts, and clinical trialists. This expertise led to robust and significant cross-expertise discussions such as how targeting epigenetics can affect the immune response that can then lead to smarter, more informative clinical trial design.
Outcomes: Future projects and collaborations include the following:
- How to identify response to immunotherapy through tertiary lymphoid structures (TLS) to correlate with improved survival
- How aging mouse models can be used to study tumor progression and the impact on the immune response
- How artificial intelligence may improve diagnosis and pathological changes in OC
- Sharing animal models of ovarian cancer between participants
- Sharing ovarian cancer tissue resources between participants (tissue microarrays)
- Sharing rare type cancer cell lines between participants
- Collaborations for multi-institutional clinical trials and grant applications have been discussed among participants
- Sharing genomic databases for exploration of research questions previously not addressed between participants
In summary, this forum has formed scientific and professional collaborations that will continue and will result in impactful papers, grants, and clinical trials.
Venue & Travel Information
800 Asilomar Avenue
Pacific Grove, CA 93950
Travel Forms
Travel forms are due 30 days prior to the start of the forum to allow enough time to plan transportation.
To help reduce transportation costs, the Foundation tries to group travelers on shuttle vans rather than providing transportation for single travelers. The times below are not exclusive but represent times that we hope to have shuttles leave the airport.
The Monterey Regional Airport (MRY) is the preferred airport as it is only 20 minutes from the venue.
- Arrival day of the forum at approximately 1:00 PM, 3:00 PM and 5:00 PM
- Departures from the venue at approximately 8:00 AM, 10:00 AM, and 12:00 PM
San Francisco International Airport (SFO) is 2 hours from the venue without traffic. The Foundation tries to prioritize International Flights and situations where flying into SFO is significantly cheaper than connecting to MRY. The times below are for guidance only, and depending on the volume of travelers, we may add an additional shuttle to and from the airport.
- Arrival day of the forum at approximately 3:00 PM
- Departures from the venue at approximately 10:00 AM
Travel Policy
Please familiarize yourself with our policies and procedures for travel. We truly appreciate you taking the time to participate in this forum. As you make your plans, please remember that we are a nonprofit organization dependent on donations and volunteers. We do NOT pay for upgrades, change fees, incurred costs resulting from a flight change, transportation to or from your local (home side) airport, meals or other incidentals.
- Travel Confirmation will be sent out within 1 week of the forum. This will include a hotel confirmation number, if there is one, and airport transfer details. We have to wait until we receive almost everyone’s travel to book airport transfer. Due to frequent airline changes, we wait until the week of the forum to send this out.
- Airport transfer is provided by Foundation staff, volunteers or arranged shuttle at specific times. If you opt to utilize Foundation airport transportation on your travel form, please be patient in receiving this information. We will send it to the week of the forum.
- Speaker agenda is not sent out prior to the forum. It will be provided upon arrival in the forum packet. We do not tell people when they are speaking because we expect everyone to attend all sessions. Sessions are all day Friday and Saturday.
- REMINDER: We do not reimburse for home side airport transfer or incidentals while traveling. We will not honor miscellaneous receipts sent for these expenses.
- Spouses are welcome to come with you at their own cost but are not allowed to attend the forum. Please no children.
What the Foundation Pays
Accommodations and meals are provided by the foundation during the forum. Airfare will be covered only if booked in accordance with our policy and only up to the amount in which you were approved for. The Foundation will also cover airport transportation on the forum side at the designated shuttle times. You can select not to utilize Foundation arranged transportation at your own expense when completing the travel form. Once your travel form is received your accommodations and airport transfer will be confirmed. Please let us know of any food allergies or other information we should be aware of on the travel forms.
- Note we do not cover upgrades, changes, late bookings, etc.
- Flights must be booked at least 30 days prior to the forum to confirm your accommodations and airport transfer.
- As a nonprofit we utilize volunteers and other methods to maximize our efforts (or our donor support) when making accommodations and arranging ground transportation. Ground transportation will be provided upon your arrival either by a foundation volunteer or arranged shuttle. You will be provided airport transportation information the week of the forum. We do not reimburse for home side airport transfer or incidentals while traveling.
Abstracts
Abstracts are due 30 days prior to the start of the meeting to allow enough time to prepare the meeting book.
The abstracts should be only one or two paragraphs outlining the theme of your presentation and should reflect the objective and spirit of the meeting (see above). Abstracts will be circulated about one week before the meeting. The meeting organizer will start requesting them a month before the meeting.
Forum Structure
The structure of the forum has been developed over years of experience.
- Participants have approximately 45 minutes, depending on the number of participants, for their presentation and discussion. The presentation is meant as a conversation start and should last about twenty minutes briefly covering background information and areas that are new or need further input. This should be structured in such a way as to lead to a lively discussion. Participants are encouraged to interrupt to ask questions or start discussions.
- A MAXIMUM of 2 slide equivalents per presentation is allowed (Power point slides should not contain more than one graph or gel per slide and no more than 5 bullet points to stress the points being made by the presenter.) We appreciate cooperation with the spirit of this guideline. Handouts are welcome but should be distributed before sessions.
- Everyone is expected to actively participate in every session and discussions.
- The time spent at the forum is relatively short, so please be familiar with papers received prior to arrival.
- It is very important that you commit to all sessions of the 2 days of the forum.
Forbeck Scholars Participation
Scholars are selected for each Forbeck Forum. These are outstanding junior clinical or post-doctoral fellows selected based on the quality and relevance of science.
- Scholars present for 30-45 minutes, depending on the number of participants
- The same presentation rules apply for scholars
- After the Forum you are selected to attend, you will attend three years of Scholar Retreats held in Lake Geneva, WI. If you attend a Fall Forum, you will attend the Spring Retreat. If you attend a Spring Forum you will attend a Fall Retreat.
- Scholars are selected by the Foundation Scientific Advisory Board and peer reviewers selected from past Forbeck Scholars.
General Program
The outline below illustrates a typical program schedule. You will receive a complete schedule, including speaking times, the Thursday the forum starts.
Frequently Asked Questions
Below are some of our most Frequently Asked Questions. If you have something new to ask, please feel free to contact us.
- Travel Confirmation will be sent out within 1 week of the forum. This will include a hotel confirmation number, if there is one, and airport transfer details. We have to wait until we receive almost everyone’s travel to book airport transfer. Due to frequent airline changes, we wait until the week of the meeting to send this out.
- Airport transfer is provided by Foundation staff, volunteers or arranged shuttle at specific times. If you opt to utilize Foundation airport transportation on your travel form, please be patient in receiving this information. We will send it to the week of the forum.
- Speaker agenda is not sent out prior to the meeting. It will be provided upon arrival in the meeting packet. We do not tell people when they are speaking because we expect everyone to attend all sessions. Sessions are all day.
- Frequently airport transfer is provided by volunteers. Please be patient on receiving this information. Airport transfer will be sent out prior to arrival.
- REMINDER: We do not reimburse for home side airport transfer or incidentals while traveling. We will not honor miscellaneous receipts sent for these expenses.