Ovarian Cancer

Mario M. Leitao, Jr, MD, FACOG, FACS, program director of Gynecologic Oncology at Memorial Sloan Kettering Cancer Center, discusses what is currently being investigated in the treatment landscape of ovarian cancers.

According to top-line results from the QUADRA study, niraparib met the primary endpoint of overall response as a fourth-line or later treatment in patients with ovarian cancer, regardless of <em>BRCA</em> status.

Olaparib tablets have been approved been the European Commission as a maintenance therapy for&nbsp;patients with platinum-sensitive relapsed high-grade, epithelial ovarian, fallopian tube or primary peritoneal cancer, who are in a complete or partial response to platinum-based chemotherapy, regardless of&nbsp;<em>BRCA</em>&nbsp;status.

Kathleen Essel, MD, a fellow at University of Oklahoma Health Science Center, discusses the findings from a recent trial investigating the safety of long-term treatment with bevacizumab in patients with ovarian cancer.&nbsp;

The FDA approved several indications throughout the month of April 2018.&nbsp;A number of drugs were granted priority review and Fast Track designation. The FDA also halted all clinical trials using&nbsp;tazemetostat as treatment, and new initiatives were introduced&nbsp;to help ease the development of genetic and genomic-based tests.&nbsp;Check out our list of all FDA happenings from April 2018.

Based on findings from the phase III ARIEL3 trial, rucaparib (Rubraca) tablets have been approved by the FDA&nbsp;for use as a maintenance treatment for patients with recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer who are in a complete or partial response to platinum-based chemotherapy, according to Clovis Oncology, the manufacturer of the PARP inhibitor.

According to initial results presented at the 2018 Society of Gynecologic Oncology Annual Meeting, 43% of the first 14 patients with platinum-resistant epithelial ovarian cancer treated with the combination of pembrolizumab (Keytruda) and mirvetuximab soravtansine (IMGN853), a folate receptor-alpha antibody drug conjugate, had partial responses.

Experts in the gynecologic oncology field share their key takeaways from the 2018 Society of Gynecologic Oncology (SGO) Annual Meeting on Women&rsquo;s Cancer, held at the Hyatt Regency Resort &amp; Convention Center in New Orleans, Louisiana, from March 24 to 27, 2018.

Ursula A. Matulonis, MD, director, Gynecologic Oncology, Dana-Farber Cancer Institute, professor of medicine, Harvard Medical School, discusses initial safety and activity findings from a phase IB escalation study of&nbsp;mirvetuximab soravtansine, a folate receptor alpha-targeting antibody-drug conjugate,&nbsp;with pembrolizumab (Keytruda) in patients with platinum-resistant epithelial ovarian cancer.

The combination of first-line platinum-containing chemotherapy plus the anti-PD-1 agent pembrolizumab (Keytruda), followed by pembrolizumab maintenance therapy, was safe and tolerable in patients with&nbsp;advanced ovarian cancer, according to preliminary data from a small clinical trial presented at the 2018 Society of Gynecologic Oncology Annual Meeting.

The results of a network meta-analysis, which compared efficacy and safety findings from studies of 3 FDA-approved PARP inhibitors as maintenance therapy for patients with relapsed platinum-sensitive ovarian cancer, demonstrated that similar efficacy results were seen across the 3 PARP inhibitors, but safety results differed.&nbsp;

According to results from the phase II MEDIOLA trial, the combination of olaparib (Lynparza), a PARP inhibitor, and durvalumab (Imfinzi), a&nbsp;PD-L1 inhibitor,&nbsp;was found to induce objective responses in over 70% of patients with relapsed, platinum-sensitive,&nbsp;BRCA-mutated ovarian cancer.

Results from a phase I/II trial indicated that durable responses could be achieved with the combination of niraparib (Zejula), a PARP inhibitor, and pembrolizumab (Keytruda), a PD-1 inhibitor, in patients with&nbsp;platinum-resistant/refractory ovarian cancer.

Rodney P. Rocconi, MD, chief of Gynecologic Oncology Service, associate director for Clinical Research, professor of Interdisciplinary Clinical Oncology, discusses a phase I trial of Vigil personalized engineered autologous tumor cells in ovarian cancer during the 2018 Society of Gynecologic Oncology Annual Meeting.

A combination regimen of pembrolizumab (Keytruda) and&nbsp;mirvetuximab soravtansine (IMGN853) induced responses in close to half of the patients in a small study of platinum-resistant ovarian cancer .

The United States Food and Drug Administration approved several maintenance therapies over the last few years for the management of platinum-sensitive recurrent ovarian cancer. Bevacizumab (Avastin), TKIs, or PARP inhibitors were among the treatments used in the clinical trials leading to these approvals.

In an analysis of the phase III ENGOT-OV16/NOVA study, baseline body weight and platelet counts served as early biomarkers for patients with platinum-sensitive, relapsed, high-grade serous epithelial ovarian, fallopian tube, or primary peritoneal cancer who would require dose modifications to their treatment with niraparib (Zejula).

According to study findings presented during the 49th Society of Gynecologic Oncology (SGO) Annual Meeting on Women&rsquo;s Cancers held in New Orleans March 24-27, clinical benefit has been found for women with recurrent ovarian cancer when using immune checkpoint inhibitors, but there was a higher rate of adverse events (AEs) than previously reported in other tumor types.

Michael Birrer, MD, PhD, professor of medicine in the Division of Hematology-Oncology, and Director of the Comprehensive Cancer Center at the University of Alabama at Birmingham, discusses current data on predicting response to PARP inhibitor therapy in ovarian cancer.