Final ANANOVA2 Survival Data Support Niraparib Plus Bevacizumab in Recurrent Ovarian Cancer

Mansoor Raza Mirza, MD, chief oncologist in the Department of Oncology at Rigshopitalet–Copenhagen University Hospital in Denmark and medical director of the Nordic Society of Gynaecological Oncology, discusses the final survival data from the randomized phase 2 NSGO-AVANOVA2/ENGOT-OV24 study, which evaluated the combination or niraparib (Zejula) plus bevacizumab (Avastin) versus niraparib alone in recurrent platinum-sensitive ovarian cancer.

According to the data presented at the 2020 American Society of Clinical Oncology (ASCO) Virtual Scientific Program, the hazard ratio for overall survival (OS) was 0.75. However, Mirza notes that this study was not powered for OS, which is why they cannot say this is statistically significant. In the context of survival, though, there is a benefit for patients receiving the combination regimen.

In regard to toxicities, there were no new safety signals with the combination. Hypertension was increased, and investigators also saw proteinuria, but these are typical toxicities of bevacizumab. According to a seperate patient-reported outcomes analysis, there was no deterioration of quality of life for patients receiving the doublet versus single-agent niraparib.

Mirza concludes there is a clear rationale for developing a randomized phase 3 clinical trial to change the current standard of care for these patients. He hopes such a trial will be able to run soon in the near future.

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