GYNECOLOGIC CANCERS

A 56-Year-Old Female With Recurrent Ovarian Cancer

An open, multicenter phase II trial of extend-release onapristone in patients with progesterone receptor–positive recurrent granulosa cell ovarian cancer, low-grade serous ovarian/primary peritoneal cancer, or endometroid endometrial cancer will demonstrate if the investigational drug will shrink or stop the cancer.

In January 2020, the FDA approved new treatment options in gastrointestinal stromal tumors, bladder cancer, and epithelioid sarcoma. The FDA also granted several Priority Review Designations, orphan drug designations, and a Fast Track designation, as well as a Breakthrough Therapy designation.

Continuous dosing of the MEK inhibitor binimetinib plus buparlisib, a PI3K inhibitor, demonstrated promising activity as treatment of patients with ovarian cancer harboring either a RAS or BRAF mutation, according to results from a phase Ib clinical trial.

Mira Hellmann, MD, discusses how the use of PARP inhibitors as treatment of patients with gynecologic cancers has evolved since they were first introduced into the treatment landscape up to studies evaluating these therapies today in a variety of patient populations, particularly in patients with ovarian cancer.

Research has shown that patients with para-aortic lymph node metastasis, human papillomavirus-18, and those with certain histocompatibility genes in their cervical tumors also have a poor prognosis. Preclinical research suggests, however, that immune checkpoint blockade with radiation can enhance immune-mediated activity in patients who have up to stage IV disease.

In an interview with Targeted Oncology, Vincent Chung, MD, discussed the findings from the pilot trial evaluating the addition of dietary supplements to combination chemotherapy in patients with unresectable pancreatic cancer. He also highlighted the importance of these findings and the next steps necessary to evaluate the role of supplements in pancreatic cancer further.

Promising antitumor activity with durable responses were demonstrated with the combination of nivolumab and ramucirumab plus paclitaxel in a phase II study of patients with advanced gastric cancer, which wsa presented at the 2020 Gastrointestinal Cancers Symposium. Among patients treated with the combination, the objective response rate was 37.2%, and all responders had a partial response.

Overall survival was meaningfully improved with treatment of pembrolizumab in first and later lines for patients with advanced gastric/gastroesophageal junction cancer with a high number of PD-L1–expressing cells in the tumor, lymphocytes, and macrophages compared with chemotherapy.

A subset of patients with GI cancers harboring&nbsp;<em>NTRK</em>&nbsp;gene fusions had positive responses to selective TRK inhibition with larotrectinib, confirming efficacy of the agent in this group. The results of the confirmatory trial were recently reported the 2020 Gastrointestinal Cancers Symposium.

Managing A Case of Heavily Pretreated Recurrent Ovarian Cancer

A phase Ib/II clinical trial of the experimental anti-mitochondrial drug devimistat in combination with cisplatin and gemcitabine has been initiated in patients with biliary tract cancer, according to a press release from Rafael Pharmaceuticals, Inc. The company will collaborate with Michigan Medicine to proceed with the randomized multicenter clinical trial.

Myriad Genetics, Inc, has submitted a supplementary premarket approval application to the FDA for the myChoice CDx test for use in predicting outcomes for women with frontline platinum-responsive advanced ovarian cancer who are treated with niraparib, a PARP inhibitor, according to a press release from Myriad Genetics, Inc., the manufacturer of the test.

Dasatinib, a second-generation Abl-tyrosine kinase inhibitor, used concurrently with an intensive chemotherapy regimen yields superior outcomes compared with imatinib plus chemotherapy in pediatric patients with Philadelphia chromosome-positive acute lymphoblastic leukemia, according to the results from the first randomized phase III clinical trial comparing the 2 drugs in this patients&nbsp;<a>population</a>.

Antonio&nbsp;Gonzalez Mart&iacute;n, MD, discusses the results from the phase III PRIMA study, which evaluated the PARP inhibitor niraparib versus placebo as a frontline treatment of patients with newly diagnosed ovarian cancer who responded to platinum-based chemotherapy.

Integrating a geriatric assessment into the care of older adults who are receiving cancer treatment in communi&shy;ty oncology practices improves patient and caregiver satisfaction and encourages commu&shy;nication about aging-related concerns, accord&shy;ing to results of a clinical trial that enrolled 541 patients with advanced cancer.

In an interview with&nbsp;Targeted Oncology, Eric Pujade-Lauraine, MD, PhD, discussed the data from the JAVELIN Ovarian 200 trial, which he presented at the 2019 Society of Gynecologic Oncology Annual Meeting. He highlighted the need for biomarkers in this space, as well as some data from an exploratory analysis from this trial.

The supplemental New Drug Application for olaparib, a PARP inhibitor, in combination with bevacizumab has been granted Priority Review by the FDA as maintenance treatment of patients with advanced ovarian cancer who are in complete or partial response to first-line platinum-based chemotherapy, based on the results from the phase III PAOLA-1 trial, according to a press release from AstraZeneca and Merck &amp; Co, Inc.1<br /> &nbsp;

The present and future benefits of telehealth in oncology can be observed through Tahoe For&shy;est Cancer Center and its affiliation with the UC Davis Cancer Center, use of other remote clinics, and participation in virtual tumor boards. Even though there are roadblocks to telehealth reaching more locations and more patients, the potential benefit warrants the time needed to get over those hurdles.

Aiwu Ruth He, MD, discusses the current role of immune checkpoint inhibitors in upper gastrointestinal and gastric cancers and which patients are most likely to benefit from the anti&ndash;PD-1 agents.