Gynecologic Oncology

Hye Sook Chon, MD, teases out some of the differences between the data with PARP inhibitors in the frontline maintenance setting and shed light on ongoing research with combinations that could broaden their utility in patients with advanced ovarian cancer.

Thomas C. Krivak, MD, discusses the significance of HRD in ovarian cancer, approved and prospective HRD tests, and considerations for genomic testing in this population.

Out-of-pocket costs for patients with ovarian cancer who have been treated with PARP inhibitors are generally low, according to recent study results from a single institution.

Robert Wenham, MD, MS, FACOG, FACS, discusses future directions with antibody-drug conjugates in the treatment of patients with ovarian cancer.

The combination of mirvetuximab soravtansine and rucaparib was found to be well tolerated, with encouraging activity reported in heavily pretreated patients with endometrial, ovarian, fallopian tube, or primary peritoneal cancer.

Dr. Coleman and Dr. Brown discuss how understandings of BRCA and patient eligibility for PARP inhibitors have evolved in ovarian cancer, the effects of frontline maintenance trials on treatment recommendations, the clinical significance of the findings from the ARIEL4 trial, and where PARP inhibition is headed in the field.

The addition of farletuzumab to carboplatin plus paclitaxel or carboplatin plus pegylated liposomal doxorubicin did not demonstrate superiority over placebo plus chemotherapy in patients with platinum-sensitive recurrent ovarian cancer who are in their first relapse and have low cancer antigen-125 levels.

The exploration of mirvetuximab soravtansine as a potentially efficacious treatment in patients with advanced, high-grade, platinum-resistant epithelial ovarian, primary peritoneal, or fallopian tube cancers with high folate receptor–alpha expression continues with the ongoing, single-arm, phase 3 SORAYA trial.

Dostarlimab demonstrated durable antitumor activity in patients with mismatch repair deficient and MMR proficient endometrial cancer, regardless of investigator assessment or blinded independent central review and immune-related RECIST or RECIST v1.1 criteria.

The GAS6/AXL inhibitor AVB-500, when combined with paclitaxel, elicited clinical benefit with favorable tolerability in patients with platinum-resistant ovarian cancer, according to data from a phase 1b study.

Jing-Yi Chern, MD, ScM, discusses the role of maintenance PARP inhibition in patients with recurrent platinum-sensitive ovarian cancer, as well as remaining questions regarding the utility of PARP inhibitors in this setting.

Erika P. Hamilton, MD, discusses the phase 2 LIO-1 trial evaluation of lucitanib and nivolumab across different gynecologic cancer subtypes.

Olaparib, when used in patients with platinum-sensitive relapsed ovarian cancer who had a known BRCA mutation and homologous recombination deficiency status, demonstrated adverse effects that proved to be consistent with the established safety profile of the PARP inhibitor.

Maintenance niraparib demonstrated clinical benefit that persisted beyond first progression in patients with platinum-sensitive recurrent ovarian cancer with or without germline BRCA mutations.  

Although the combination of olaparib and cediranib showcased modest efficacy over cediranib alone in patients with recurrent, metastatic or persistent endometrial cancer, the difference was not statistically significant.

Maintenance olaparib showcased progression-free survival benefit in almost half of the patients with ovarian cancer vs 21% of those who received placebo, including consistent benefit in high- and low-risk patients.

Niraparib in combination with bevacizumab continued to showcase a progression-free survival benefit in patients with advanced ovarian cancer who previously received frontline platinum-based chemotherapy and bevacizumab.

Eribulin induced limited activity with a favorable toxicity profile in patients with recurrent or advanced cervical cancer, and prior exposure to paclitaxel was associated with decreased response to the agent.

Dostarlimab plus niraparib and bevacizumab showcased favorable antitumor activity and tolerability in patients with platinum-resistant ovarian cancer.

The combination of pembrolizumab and lenvatinib improved progression-free and overall survival, as well as response rates, compared with chemotherapy in patients with advanced endometrial cancer who received prior platinum-based chemotherapy, irrespective of mismatch repair status, according to phase 3 findings of the Study-309/KEYNOTE-775 trial.

CA-125 surveillance alone could be used to detect disease progression in patients with advanced ovarian cancer and an abnormal CA-125 level at the beginning of frontline maintenance therapy with olaparib and bevacizumab, according to an analysis from the phase 3 PAOLA-1.

Rachel N. Grisham, MD, discusses the mechanism of action of VS-6766 in patients with recurrent low-grade serous ovarian cancer.

In our exclusive interview, Dr. Monk and Dr. Herzog discuss the importance of molecular testing in ovarian cancer and the utility of PARP inhibitor maintenance and treatment.

Robert Wenham, MD, MS, FACOG, FACS, discusses the basis for combining chemotherapy, PARP inhibitors, and VEGF inhibitors with immunotherapy in ovarian cancer and ongoing research with ADCs in the field.

A phase 3 trial evaluating single-agent cemiplimab will be stopped early due to positive results demonstrating an overall survival benefit over chemotherapy in patients with recurrent or metastatic cervical cancer who previously received chemotherapy.