Ovarian Cancer

The early development of PARP inhibitors in 2003 focused on their use in combination with cytotoxic chemotherapy agents, but this was eventually abandoned because of excess toxicity.

In an interview with Targeted Oncology, Kathleen Moore, MD, discussed the data surrounding mirvetuximab soravtansine in this patient population and the plans to reevaluate the ADC following the results from the FORWARD I/GOG 3011 clinical trial. She also highlighted other areas of investigation for women with platinum-resistant ovarian cancer.

Kathleen Moore, MD, discusses the findings from the phase III FORWARD-1 trial that investigated mirvetuximab soravtansine in women with folate receptor alpha–positive platinum-resistant ovarian cancer. These findings were presented at the 2019 ESMO Congress.

PARP inhibitors are increasingly relevant for frontline maintenance indications and potentially in combination with chemotherapy for treatment-na&iuml;ve ovarian cancer, including for those with <em>BRCA</em>-wildtype disease, Leslie M. Randall, MD, said to the audience at the <em>37th Annual</em> CFS.

In October 2019, the FDA approved a new treatment option for patients with advanced ovarian, fallopian tube, or primary peritoneal cancer, as well as a new dosing regimen for patients receiving moderately emetogenic chemotherapy. Additionally, the FDA granted breakthrough therapy designations to 2 therapies, as well as an orphan drug designation, a priority review, and 2 fast track designations.

The FDA has approved niraparib for the treatment of patients with advanced ovarian, fallopian tube, or primary peritoneal cancer treated with &ge;3 prior chemotherapy regimens and whose cancer is associated with homologous recombination deficiency positivity.

The FDA has approved a supplemental New Drug Application for a single dose of aprepitant injectable emulsion for intravenous use in patients receiving moderately emetogenic chemotherapy. The approval expands the dose for aprepitant to include a 130 mg single-dose regimen for the prevention of acute and delayed chemotherapy-induced nausea and vomiting.<br /> &nbsp;

The case for the combination of olaparib and durvalumab in patients with metastatic breast cancer and relapsed ovarian cancer with germline&nbsp;BRCA&nbsp;mutations was strengthened based on the updated results from the phase I/II MEDIOLA, which was covered in 2 separate presentations at the 2019 ESMO Congress.

Robert L. Coleman, MD, professor of medicine, The University of Texas MD Anderson Cancer Center, explains the rationale for the VELIA trial of veliparib with frontline chemotherapy and maintenance in patients with high-grade ovarian cancer.

Following the 2019 ESMO Congress, experts across various fields highlighted some next steps and how these treatment options will improve the treatment landscape for patients with ovarian, lung, breast, GI, or GU cancers. Overall, the abstracts presented at this year&rsquo;s meeting will change the treatment paradigm in a number of patient populations.

The FDA has granted a fast track designation to navicixizumab for the treatment of patients with high-grade ovarian, primary peritoneal, or fallopian tube cancer who have received &ge;3 prior therapies and/or prior bevacizumab.

In a randomized trial, treatment with MEK inhibitor trametinib showed significant improvement in progression-free survival and overall survival in patients with recurrent, low-grade serous ovarian cancer.<br /> &nbsp;

The addition of direct oral oral anticoagulants for the management of venous thromboembolism in patients with cancer is the latest change to previous guidelines issued by the American Society of Clinical Oncology.

Patients with high-grade serous ovarian cancer experienced a 32% reduction in the risk of progression or death with frontline combination veliparib plus carboplatin and paclitaxel followed by veliparib maintenance, according to the data from the phase III VELIA trial presented at the 2019 ESMO Congress, and simultaneously published in the&nbsp;New England Journal of Medicine.

Using a measure known as the growth modulation index, patients with TRK fusion&ndash;positive cancers who were treated with larotrectinib had a clinically meaningful improvement in progression-free survival compared with the time to progression on their prior treatment, an analysis of patients enrolled in 1 of 3 clinical trials has found.

Three clinical trials presented at the 2019 ESMO Congress show that the tropomyosin receptor kinase&nbsp;inhibitor larotrectinib continues to show anti-tumor activity, including long-lasting objective responses and low toxicity, according to results from an integrated analysis.

Robert L. Coleman, MD, FACOG, FACS, discusses&nbsp;the results of the phase III VELIA trial in patients with advanced ovarian cancer.&nbsp;

The combination of olaparib and bevacizumab as frontline maintenance improved the median progression-free survival by 5.5 months over bevacizumab and placebo in patients with&nbsp;newly diagnosed, advanced ovarian cancer following prior treatment with a platinum-based chemotherapy plus bevacizumab, according to the phase III PAOLA-1 findings presented at the 2019 ESMO Congress.

Median progression-free survival was improved by 5.6 months with PARP inhibitor niraparib as first-line treatment for patients with newly diagnosed, advanced ovarian cancer who responded to platinum-based chemotherapy&nbsp;compared with placebo, according to data from the phase III PRIMA study presented at the ESMO Congress 2019 and simultaneously published in the <em>New England Journal of Medicine</em>.

Cediranib in combination with olaparib demonstrated an improvement in&nbsp;progression-free survival when used as treatment for patients with platinum-resistant ovarian cancer (PROC). However, the difference in PFS compared with chemotherapy did not achieve statistical significance, according to a randomized trial presented at the 2019 ESMO Congress.

In the phase III PRIMA trial, niraparib demonstrated a benefit in progression-free survival compared with placebo when used as maintenance therapy following platinum-based chemotherapy for patients with ovarian cancer treated in the first line.&nbsp;The PFS benefit was found to be statistically significant, regardless of patients&rsquo; biomarker status, meeting the primary endpoint of the trial.&nbsp;