Dedicated  women’s cancer centre and ROCK – PPP model/ grant applications

The ROCK group  concept:

Implementation and health care services/policy  Research

– Need uniform protocol, governance, management and resources -dedicated manpower, money, time, energy:  focused investment to improve ovarian cancer care
– Individuals with a common mission and vision ( operation:  regional/ national/ global)

  • Expert team – surgical, medical oncology, anaesthesia, super specialities, nursing, research and operations
  • Volunteer medical/nursing staff
  • Government – PPP model ( 2 or 3 lead sites to cater women with diverse SES)
  • Donor
  • Philanthropists
  • Survivors and advocates
  • Support from International and National centres of excellence
  • Industry

 Patient right to choose – centres and surgeons according to affordability but common treatment protocol, expertise  and standards must be assured and ensured

  • Clinical MDT
  • Trial MDT
  • Precision medicine MDT

Implementation steps:

  1. Virtual group: website
  2. Online and Telemedicine support: Patient information, guidance, advice on current treatment protocol, survivor group and campaigning for awareness, advocacy and treatment: visionary and missionary mode ( patient has right to choose the dedicated and trained team with repute and demonstrable track record)- emphasis-quality and survival
  3. Application for funding (Public and Private)

Step wise scaling up
– Institutes where The ROCK group can be housed/ infrastructures can be used on payment basis  (clinical and research)
– Recruitment- volunteers and salaried
– Number of women to be seen and treated annually
– Number of outreach centres
– Education, research and training
– data science and intelligence

High resource Low resource Alternative KolGo Trg approach
Optimal/ complete cytoreductive surgery Yes, ESGO Criteria
>50% Primary surgery
>80% optimal CTR
Requires Manpower resource – training and peri-op care Most cost effective intervention IGCS fellowship ROCK
Intraperitoneal chemotherapy/HIPEC NCCN guidelines Patchy- has cost implications HIPEC in biological sub groups HIPEC-HR
 BRCA genetic testing- HBOC and prevention Routine Patchy- lack of genetic counsellors and tracing at risk individuals Nurse led genetic counselling and PPI NuGenA
HRD testing Routine- costly genomic studies Not available/ QA/ costs Low cost academic HRD assay (Rad51) PROVAT/ Biobanking
PARP inhibitors/ Avastin Routine and Standard of care

Not accessible/ available/ costly

PFS will be different

Intermittent / less than  daily dosing/ subgroups



Treatment of recurrence Trials/ targeted T/T options

Limited options

OS not prolonged

Hormones/oral chemo/AYUSH



Quality of life/ Morbidity/ cost Routine Important but neglected end points QAPFS/QTWIST SOCQER-IND, HEPTROC, MOREPARP
Survivorship Routine Not well established Snowballing KolGo Surv/ Sarbojaya