Commentary
Video
Author(s):
Hye Sook Chon, MD, discusses the DUO-E trial of frontline durvalumab plus chemotherapy followed by durvalumab and olaparib in endometrial cancer.
Hye Sook Chon, MD, gynecologic oncologist, Gynecologic Oncology Program, Moffitt Cancer Center, discusses updated findings from the phase 3 DUO-E trial (NCT04269200) of frontline durvalumab (Imfinzi) plus carboplatin and paclitaxel followed by durvalumab with or without olaparib (Lynparza) in patients with advanced or recurrent endometrial cancer.
DUO-E enrolled patients with newly diagnosed International Federation of Gynecology and Obstetrics 2009 stage III or IV or recurrent endometrial cancer. The primary end point of the DUO-E trial was progression-free survival (PFS); overall response rate (ORR) and duration of response (DOR) served as key secondary end points.
In the intent-to-treat population, the median PFS was 15.1 months (95% CI, 12.6-20.7) with durvalumab plus chemotherapy andolaparib (n = 239) compared with 10.2 months (95% CI, 9.7-14.7) in the durvalumab and chemotherapy arm (n = 238; HR, 0.78; 95% CI, 0.61-0.99) and 9.6 months (95% CI, 9.0-9.9) in the chemotherapy alone arm (n = 241; HR, 0.55; 95% CI, 0.43-0.69; P < .0001). The HR between the durvalumab plus chemotherapy arm and the chemotherapy alone arm was 0.71 (95% CI, 0.57-0.89; P = .003). The 18-month PFS rates with durvalumab plus chemotherapy and olaparib, durvalumab and chemotherapy, and chemotherapy alone were 46.3%, 37.8%, and 21.7%, respectively.
The ORR was 63.6% in the durvalumab/chemotherapy/olaparib arm, including a 16.3% complete response (CR) rate. The respective ORRs in the durvalumab plus chemotherapy and chemotherapy alone arms were 61.9%, including a 12.9% CR rate, and 55.1%, including a 9.6% CR rate. The odds ratio between the durvalumab and olaparib arm vs the chemotherapy alone arm was 1.44 (95% CI, 0.95-2.18); this value was 1.32 (95% CI, 0.89-1.98) between the durvalumab plus chemotherapy and chemotherapy alone arms.
The median DORs in the durvalumab/chemotherapy/olaparib, durvalumab/chemotherapy, and chemotherapy alone arms were 21.3 months (IQR, 8.1-29.9), 13.1 months (IQR, 6.0-NR), and 7.7 months (IQR, 5.1-13.5), respectively. At 24 months, 47.1%, 38.0%, and 14.8% of patients in these respective arms remained on treatment.