Dr Dorigo on the Clinical Benefit with Maveropepimut-S in Recurrent Ovarian Cancer

Oliver Dorigo, MD, PhD, member, Stanford Cancer Institute; associate professor, obstetrics and gynecologic oncology, Stanford University Medical Center; director, gynecologic oncology fellowship, clinical research group for gynecologic cancer trials, gynecologic oncology clinical care program, Mary Lake Polan Gynecologic Oncology Research Laboratory, and obstetrics and gynecology, Division of Gynecologic Oncology, Stanford Health Care, discusses the clinical efficacy of maveropepimut-S (MVP-S) in patients with recurrent ovarian cancer.

The use of MVP-S plus an intermittent low dose of cyclophosphamide in patients with advanced recurrent ovarian cancer was evaluated in the phase 1b/2, multicenter DeCidE1 trial (NCT02785250), Dorigo begins. The trial enrolled patients with recurrent, epithelial ovarian, fallopian tube, or peritoneal cancer. Patients were randomized to MVP-S and cyclophosphamide with or without the recommended phase 2 dose of epacadostat. Primary end points included overall response rate (ORR), disease control rate (DCR), and safety. 

In the study, MVP-S and cyclophosphamide demonstrated clinical benefit in this population, with an ORR of 21% and DCR of 63%, Dorigo states. Of the 11 patients with platinum-resistant disease, 4 were treated beyond 6 months, Dorigo says. Similarly, 4 out of 8 patients with platinum-sensitive disease were treated beyond 1 year, he adds. These data indicate that the combination can elicit durable responses in patients regardless of platinum sensitivity, Dorigo explains.

Patients with an increased number of immune effector T cells and B cells were found to experience a heightened response to treatment, Dorigo continues. Furthermore, MVP-S plus cyclophosphamide produced a positive survivin-specific T-cell response in 87% of patients, he notes.

Investigation of the tumor microenvironment revealed that genes involved in the WNT/beta-catenin signaling pathway are highly upregulated in patients who do not respond to this regimen, indicating their potential predictive value, Dorigo details. Future research may evaluate the utility of these genes in designing biomarker-driven approaches in ovarian cancer, he concludes.

Editor’s Note: Dr Dorigo reports serving as an independent contractor or in an advisory role for IMV, GSK, Genentech, Merck, and Epsila Bio; he received grants or research funding from IMV, AstraZeneca, Bioeclipse, Genentech, Millenium, Novartis, and Pharmamar.