Dr David M. O’Malley reviews ESMO 2021 updates evaluating the use of combination anti-PD-1 and anti-CTLA4 agents for recurrent and metastatic cervical cancer.
David M. O’Malley, MD: At this past ESMO [European Society for Medical Oncology Congress], I had the honor of presenting the single-arm trial with balstilimab, the PD-1 inhibitor, and zalifrelimab, a CTLA4 inhibitor, in patients with recurrent progressive or metastatic cervical cancer who had previously been treated with a platinum doublet with or without bevacizumab. We found in that trial that the efficacy was modestly improved over the single-agent balstilimab with a 26% overall response rate and, very interestingly, a 33% response rate in the PD-L1 positive patients.
The other part that I’m so excited about is that the complete response rate in the entire population approached 9%. With this combination of the PD-1 inhibitor plus CTLA4 inhibitor, we’re seeing modest improvements in the efficacy. We’re also seeing significant durability of response where duration response wasn’t met, and potentially patients who are having complete responses. We don’t know yet, but it’s possible that in second-line cervical cancer, patients with recurrent cervical cancer could be cured of their disease in the second-line setting. These results have led to the design of a randomized phase 2 trial, GOG-3028, or the RaPiDS study. It’s a 2-arm trial with balstilimab, the PD-1 inhibitor, vs balstilimab and zalifrelimab, the CTLA4 inhibitor. That’s ongoing and enrolling. For patients who haven’t had a prior immunotherapy, this is the trial I’d strongly encourage you consider.
Transcript Edited for Clarity
KEYNOTE-A18 Supports Pembrolizumab and CRT as New Standard in High-Risk Cervical Cancer
September 14th 2024Pembrolizumab combined with chemoradiotherapy followed by pembrolizumab monotherapy significantly improved survival compared to chemoradiotherapy alone in patients with high-risk locally advanced cervical cancer.
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