Ovarian highlights from ESMO 2019

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Published: 28 Sep 2019
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Prof Robert Coleman - MD Anderson Cancer Center, Houston, USA

Prof Robert Coleman speaks to ecancer at ESMO 2019 in Barcelona about notable studies on ovarian cancer presented at the conference.

ecancer's filming has been kindly supported by Amgen through the ecancer Global Foundation. ecancer is editorially independent and there is no influence over content.

 

This is great meeting for ovarian cancer for this year. Obviously the three Presidential plenaries are looking at the role of PARP inhibitors in various different settings. So there’s the VELIA/GOG-3005 trial I just mentioned; there’s the PAOLA-1 trial which is looking at the contribution of olaparib to bevacizumab. Many of your listeners may know that paclitaxel carboplatinum is given with bevacizumab based on the support of the ICON7 trial in the EU and the GOG-0218 trial in the US. So this is a relevant topic because we weren’t sure whether or not we could add olaparib safely, or a PARP inhibitor safely, to antiangiogenesis therapy in the maintenance setting. So we’ll see today that that’s an efficacious route as well. Then in the PRIMA study what we’ve seen is that we can expand the cohort away from these biomarker defined groups such as BRCA and HRD to essentially include this patient population, a broader patient population, that benefit from a PARP inhibitor, in this case niraparib. So, for ovarian cancer front line therapy dramatic changes – two new PARP inhibitors in new settings and then the addition of PARP inhibitors to an antiangiogenesis strategy so that’s very exciting.

In the recurrent space we’re going to hear about the FORWARD-1 trial which is looking at mirvetuximab which is an antibody-drug conjugate tagged to folate receptor. This trial was a phase III that was ultimately negative but it showed some significant activity, particularly in the biomarker positive group. This has led to the intent to actually restudy this population in a more well-defined study group. So this is an active compound that could be rebooted as another phase III trial to help patients in the platinum resistant setting.

Then I don’t want to miss the opportunity to highlight the merits of GOG-0281. This is a phase III trial that’s looking at a rare ovarian cancer subtype called low grade serous ovarian cancer. We know historically that chemotherapy has not been a very active compound or strategy in that disease and this is a disease we frequently use endocrine therapy. So what we looked at in the study was to compare a MAP kinase inhibitor, a MEK inhibitor, because of the frequent alteration of the MAP kinase pathway, versus physician’s choice chemotherapy or hormones. What we showed in this study, as you’ll see, was that there was a significant benefit in progression free survival and objective response for patients getting a MEK inhibitor. So now we’re introducing a completely new class of drug to a rare ovarian cancer subtype. So, again, a tremendous meeting for patients with ovarian cancer.