Ovarian Cancer

Before a community oncology practice considers getting involved in clinical trials research, there are many factorsto consider. Perhaps foremost is the fact that cancer clinical trials provide the evidence base for new advances in oncology. 

Artificial intelligence has made inroads in many industries—banking, finance, security—but its adoption in healthcare has been lagging and real-world clinical implementation has yet to become a reality. Nonetheless, proponents say it is only a matter of time and pilot programs are starting to yield some practical results. 

In an interview with&nbsp;<em>Targeted Oncology, </em>David O&rsquo;Malley, MD, discussed the updates with bevacizumab and PARP inhibitors as a treatment and maintenance therapy option for patients with ovarian cancer and recurrent disease. He also discussed considerations for selecting the right agent for the right patient.

Gynecologic oncology experts reflect on some of the most significant data presented during the 2019 SGO Annual Meeting, which underscored how the field is moving toward a precision medicine approach.

A pivotal phase III INNOVATE-3 trial investigating the efficacy of tumor-treating fields (TTFields; Optune) combined with paclitaxel in patients with recurrent, platinum-resistant ovarian cancer has been initiated, according to Novocure, the company developing the device.

Ramez N. Eskander, MD, discusses the current outlook for the frontline treatment landscape in ovarian cancer.

David Cibula, MD,&nbsp;highlights the phase II data on DCVAC/OvCA in combination with chemotherapy for patients with relapsed, platinum-sensitive ovarian cancer, and how it could impact future treatment approaches for this population.

The phase III JAVELIN Ovarian PARP 100 study has been discontinued,&nbsp;according to Merck KGaA and Pfizer, the companies that collaborated on the trial.^&nbsp;The ongoing trial was investigating the efficacy and safety&nbsp;of avelumab in combination with chemotherapy followed by maintenance avelumab in combination with talazoparib in patients with locally advanced or metastatic ovarian cancer.

Olaparib combined with neratinib may be a novel treatment option for patients with&nbsp;HER2-positive, homologous recombination&ndash;proficient ovarian cancer tumors that are resistant to chemotherapy, preclinical findings presented during the&nbsp;2019 SGO Annual Meeting showed.<br /> &nbsp;

Ursula A. Matulonis, MD, discusses the survival results from an analysis of the QUADRA trial in heavily pretreated patients with recurrent ovarian cancer.

Women with recurrent ovarian cancer treated with the combination of&nbsp;pembrolizumab, bevacizumab, and metronomic cyclophosphamide had a 95% disease control rate and a 40% overall response rate, according to findings from an&nbsp;open-label phase II study presented during the&nbsp;2019 SGO Annual Meeting.

Activity was seen with lenvatinib plus a weekly dose of paclitaxel in patients with recurrent endometrial and platinum-resistant epitherlial ovarian cancer, according to a presentation at the 50th SGO Annual Meeting. The combination resulted in a 65% overall response rate in a phase I trial.

Floor J. Backes, MD,&nbsp;discusses the results from a phase I trial investigating the combination of lenvatinib (Lenvima) and paclitaxel in patients with recurrent ovarian, fallopian tube, or peritoneal cancers.

Patients with high-risk ovarian cancer being treated with niraparib experienced a decrease in adverse events when treated with a&nbsp;200- or 300-mg individualized starting dose based on bodyweight and platelet count compared with patients who received a fixed starting dose of 300 mg, according to data from a recent analysis of the ongoing&nbsp;ENGOT-OV26/PRIMA study.

Repeated use of PARP inhibitors may be a beneficial treatment strategy in the future for women with recurrent epithelial ovarian cancer, according to the&nbsp;results of a retrospective, multi-institutional study presented at the 2019 SGO Annual Meeting. The findings suggested that prior exposure to PARP inhibition may not lead to resistance, which could lead to increased use of repeat PARP treatment going forward.&nbsp;

Treatment with maintenance niraparib led to extended progression-free survival time in patients with recurrent ovarian cancer without the patients experiencing symptoms or toxicity compared with placebo, according to results of an analysis from the phase III ENGOT-OV16/NOVA trial. In patients with&nbsp;germline <em>BRCA</em>-mutated disease, the benefit was increased 4-fold and in patients&nbsp;non&ndash;germline&nbsp;<em>BRCA</em>-mutated ovarian cancer the benefit was increased 2-fold.&nbsp;

Ahead of the 50th Annual SGO Meeting, Shannon Westin, MD discussed the key takeaways from a case chat and highlighted some data she is looking forward to at the meeting for patients with recurrent ovarian cancer. She also highlighted other data that will play an important part in this treatment landscape and for patients with recurrent cervical cancer.

The healthcare community is still awaiting a response from the Centers for Medicare &amp; Medicaid Services to the opposition of the agency&rsquo;s proposal to substantially revise the Medicare Part D protected drug classes.

Overtreating men 70 years or older with prostate cancer cost Medicare more than $1.2 billion from 2004 to 2007, according to the results of a retrospective study using the Surveillance, Epidemiology, and End Results&ndash;Medicare linked database.

The phase III FORWARD I trial fell short of its primary endpoint, as findings showed the antibody-drug conjugate mirvetuximab soravtansine did not result in a&nbsp;progression-free survival improvement compared with&nbsp;chemotherapy&nbsp;in patients with folate receptor alpha&ndash;positive, platinum-resistant ovarian cancer and in an overall patient population.

Advances in checkpoint inhibitor therapy have gained speed in cancer care; however, ovarian cancer has yet to see any approved indications for immunotherapy agents, said Lana E. Kandalaft, PharmD, PhD, to an audience at the European Society for Medical Oncology 2018 Immuno-Oncology Congress.

Targeted therapy has effectively been established as an option for patients with ovarian cancers. However, beyond PARP inhibition in the <em>BRCA</em>-mutated or homologous recombination deficient population, questions remain about how to best treat these patients,&nbsp;Ramez N. Eskander, MD, said at the 2019 SGO Annual Winter Meeting.