SGO Annual Meeting

Ursula A. Matulonis, MD, discusses the survival results from an analysis of the QUADRA trial in heavily pretreated patients with recurrent ovarian cancer.

Women with recurrent ovarian cancer treated with the combination of pembrolizumab, bevacizumab, and metronomic cyclophosphamide had a 95% disease control rate and a 40% overall response rate, according to findings from an open-label phase II study presented during the 2019 SGO Annual Meeting.

Activity was seen with lenvatinib plus a weekly dose of paclitaxel in patients with recurrent endometrial and platinum-resistant epitherlial ovarian cancer, according to a presentation at the 50th SGO Annual Meeting. The combination resulted in a 65% overall response rate in a phase I trial.

Floor J. Backes, MD, discusses the results from a phase I trial investigating the combination of lenvatinib (Lenvima) and paclitaxel in patients with recurrent ovarian, fallopian tube, or peritoneal cancers.

Patients with high-risk ovarian cancer being treated with niraparib experienced a decrease in adverse events when treated with a 200- or 300-mg individualized starting dose based on bodyweight and platelet count compared with patients who received a fixed starting dose of 300 mg, according to data from a recent analysis of the ongoing ENGOT-OV26/PRIMA study.

Repeated use of PARP inhibitors may be a beneficial treatment strategy in the future for women with recurrent epithelial ovarian cancer, according to the results of a retrospective, multi-institutional study presented at the 2019 SGO Annual Meeting. The findings suggested that prior exposure to PARP inhibition may not lead to resistance, which could lead to increased use of repeat PARP treatment going forward. 

Treatment with maintenance niraparib led to extended progression-free survival time in patients with recurrent ovarian cancer without the patients experiencing symptoms or toxicity compared with placebo, according to results of an analysis from the phase III ENGOT-OV16/NOVA trial. In patients with&nbsp;germline <em>BRCA</em>-mutated disease, the benefit was increased 4-fold and in patients&nbsp;non&ndash;germline&nbsp;<em>BRCA</em>-mutated ovarian cancer the benefit was increased 2-fold.&nbsp;

Experts in the gynecologic oncology field share their key takeaways from the 2018 Society of Gynecologic Oncology (SGO) Annual Meeting on Women&rsquo;s Cancer, held at the Hyatt Regency Resort &amp; Convention Center in New Orleans, Louisiana, from March 24 to 27, 2018.

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.&nbsp;

According to results from the phase II MEDIOLA trial, the combination of olaparib (Lynparza), a PARP inhibitor, and durvalumab (Imfinzi), a&nbsp;PD-L1 inhibitor,&nbsp;was found to induce objective responses in over 70% of patients with relapsed, platinum-sensitive,&nbsp;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&nbsp;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&nbsp;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&nbsp;HER2-positive uterine serous carcinoma (USC), according to findings from a small randomized trial.

Alessandro D. Santin, MD, a professor of obstetrics, gynecology, and reproductive sciences at Yale School of Medicine, discusses results of a randomized phase II trial of trial of carboplatin-paclitaxel compared to carboplatin-paclitaxel-trastuzumab (Herceptin) in advanced or recurrent uterine serous carcinomas that overexpress HER2/neu during the 2018 Society of Gynecologic Oncology Annual Meeting.

The United States Food and Drug Administration approved several maintenance therapies over the last few years for the management of platinum-sensitive recurrent ovarian cancer. Bevacizumab (Avastin), TKIs, or PARP inhibitors were among the treatments used in the clinical trials leading to these approvals.

A prospective study found that implementing&nbsp;an &ldquo;ultra-restrictive&rdquo; opioid prescription protocol for gynecologic surgery had led to&nbsp;an 89% reduction in opioid tablets dispensed at discharge and a high rate of patient satisfaction.

In an analysis of the phase III ENGOT-OV16/NOVA study, baseline body weight and platelet counts served as early biomarkers for patients with platinum-sensitive, relapsed, high-grade serous epithelial ovarian, fallopian tube, or primary peritoneal cancer who would require dose modifications to their treatment with niraparib (Zejula).

According to study findings presented during the 49th Society of Gynecologic Oncology (SGO) Annual Meeting on Women&rsquo;s Cancers held in New Orleans March 24-27, clinical benefit has been found for women with recurrent ovarian cancer when using immune checkpoint inhibitors, but there was a higher rate of adverse events (AEs) than previously reported in other tumor types.

Michael Birrer, MD, PhD, professor of medicine in the Division of Hematology-Oncology, and Director of the Comprehensive Cancer Center at the University of Alabama at Birmingham, discusses current data on predicting response to PARP inhibitor therapy in ovarian cancer.

Kathleen N. Moore, MD, assistant professor, Stephenson Cancer Center, The University of Oklahoma, discusses the international, randomized phase III NOVA trial for recurrent platinum-sensitive ovarian cancer.

Adding an immunotherapeutic agent to chemotherapy had no impact on survival in patients with recurrent, platinum-resistant ovarian cancer, according to a late-breaking trial reported at the 2017 Society of Gynecologic Oncology Annual Meeting.

An immunotherapy targeting human papillomavirus-infected cells led to an unprecedented 1-year survival in patients with recurrent, metastatic cervical cancer, according to a phase II study reported at the 2017 Society of Gynecology Oncology Annual Meeting.

Maintenance chemotherapy failed to improve survival rates for women in complete remission from ovarian cancer after debulking surgery and adjuvant platinum-based chemotherapy, a large randomized trial showed.

Kathleen N. Moore, MD, discusses the use of PARP inhibitors such as niraparib for the treatment of ovarian cancer &ndash; advances that could be practice changing, she says.

A 7-transcript classifiers effectively predicted metastatic disease for patients with endometrioid endometrial cancer, with added promise shown when the gene expression signature was combined with pathologic features.

Mismatch repair&ndash;deficient endometrial cancers exhibited significantly higher levels of PD-L1 expression compared with MMR-intact tumors.

Alon Altman, MD, associate professor, Department of Obstertrics, Gynecology and Reproductive Sciences, University of Manitoba, discusses neoadjuvant chemotherapy for patients with high-grade serous carcinoma. Across the world, many centers have shifted to more patients receiving neoadjuvant chemotherapy followed by surgery and further chemotherapy.

Results of a recent phase III trial suggested that the PARP inhibitor niraparib warrants consideration for patients with recurrent, platinum-sensitive, high-grade ovarian cancer, irrespective of <em>BRCA</em> status, a reviewer of the study concluded.

Jubilee Brown, MD, obstetrician-gynecologist, Levine Cancer Institute, Carolinas HealthCare System, discusses genetic counseling for patients with breast and ovarian cancer.