Barbara Buttin, MD, provided insight on the phase 3 DUO-O trial and what it implies for the future of ovarian cancer treatment.
Barbara Buttin, MD, a gynecologic oncologist at City of Hope Chicago, discusses the interim analysis findings from the phase 3 DUO-O trial (NCT03737643) of bevacizumab (Avastin) plus olaparib (Lynparza), and durvalumab (Imfinzi) as maintenance therapy for patients with newly-diagnosed advanced ovarian cancer and non BRCA mutations.
0:08 | We tend to look at patients with advanced ovarian cancer patients right now in terms of stratifying everyone based on biomarker status. So, we're looking at mutation status first, do they have BRCA mutations or BRCA-related genes? That’s only going to cover about 25% or so of all patients. If they don't, then we're going to do genomic analysis of the tumor to see if they have homologous recombination deficient [HRD], and we treat them based on that as far as whether they're a candidate for PARP inhibition in remission. If they're neither one of those things then we have the patients who are BRCA-negative, HRD-negative ovarian cancer patients and they still have the toughest prognosis. These stage 3 and 4 patients still have the toughest prognosis. Right now, the standard of care for them is chemotherapy plus bevacizumab and, of course, surgery. Then once patients are in remission, we give bevacizumab maintenance and bevacizumab alone has never really achieved an overall survival benefit.
1:29 | So, we've never seen an overall survival benefit in this group of patients. We've had a PFS benefit with use of bevacizumab over placebo but never an overall survival benefit. So, now suddenly, we have the addition of durvalumab [Imfinzi] and then a PARP inhibitor added into the maintenance for that group of patients. And, we have a significant improvement in PFS and looks like overall survival hopefully, once that's finalized, is also going to be significant. So that's going to be a first that's going to happen for this group of patients.
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