GYNECOLOGIC CANCERS

A Case of Advanced Serous Ovarian Cancer

A Case of Platinum-Sensitive Epithelial Ovarian Cancer

Based on findings from the phase III ARIEL3 trial, rucaparib (Rubraca) tablets have been approved by the FDA 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’s Cancer, held at the Hyatt Regency Resort & Convention Center in New Orleans, Louisiana, from March 24 to 27, 2018.

Jaron Mark, MD, gynecologic oncology fellow at Roswell Park Comprehensive Cancer Center, discusses findings from a restrictive protocol that limited the number of opioids prescribed after gynecologic surgeries. Patients looked at in this trial had undergone ambulatory or minimally invasive procedures. 

Several new indications were approved by the FDA in March, including blinatumomab (Blincyto) for MRD+ ALL, brentuximab vedotin (Adcetris) for Hodgkin lymphoma, and a 4-week nivolumab (Opdivo) dosing schedule across several indications. Here’s a look back on the FDA happenings for the month of March 2018.

Ira Winer, MD, PhD, assistant professor in the the Division of Gynecologic Oncology at Wayne State University, discusses the outlook on immunotherapy in the treatment landscape of gynecologic cancers. 

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 mirvetuximab soravtansine, a folate receptor alpha-targeting antibody-drug conjugate, with pembrolizumab (Keytruda) in patients with platinum-resistant epithelial ovarian cancer.

Blinatumomab (Blincyto) has been granted an accelerated approval by the FDA for the treatment of patients with B-cell precursor acute lymphoblastic leukemia who are in remission but still have minimal residual disease.

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 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. 

According to results from the phase II MEDIOLA trial, the combination of olaparib (Lynparza), a PARP inhibitor, and durvalumab (Imfinzi), a PD-L1 inhibitor, was found to induce objective responses in over 70% of patients with relapsed, platinum-sensitive, 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 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 mirvetuximab soravtansine (IMGN853) induced responses in close to half of the patients in a small study of platinum-resistant ovarian cancer .

When trastuzumab (Herceptin) was added to chemotherapy, a more than 50% improvement in progression-free survival (PFS) was observed compared with chemotherapy alone in patients with HER2-positive uterine serous carcinoma (USC), according to findings from a small randomized trial.