Epithelial Ovarian Cancer: Comparing Targeted Treatments With Standard-of-Care Chemotherapy

By: Victoria Kuhr, MS
Posted: Tuesday, January 21, 2025

Angeles Alvarez Secord, MD, MHSc, of the Duke Cancer Institute, Durham, North Carolina, and colleagues observed that the VEGFR tyrosine kinase inhibitor cediranib—alone or in combination with the PARP inhibitor olaparib—demonstrated some evidence of durable clinical activity in patients with platinum-resistant or platinum-refractory epithelial ovarian cancer compared with standard-of-care chemotherapy. However, this activity was on the basis of progression-free survival alone, and cediranib-containing arms were not superior to the standard chemotherapy. These findings were published in the Journal of Clinical Oncology.

“It is warranted to do further biomarker studies beyond evaluating homologous recombination deficiency and [loss of heterozygosity] to identify the molecular subgroup of patients who may respond to this intervention,” said the study authors.

This open-label, four-arm, randomized phase II/III study enrolled patients with high-grade serious/endometrioid platinum-resistant or platinum-refractory epithelial ovarian cancer who had received one to three previous therapies. The treatment arms follow: standard-of-care chemotherapy (SOC: once-weekly paclitaxel, topotecan, or pegylated liposomal doxorubicin); cediranib, olaparib, or the combination of cediranib and olaparib. Interim progression-free survival analysis was determined for selected treatment arms to advance to phase III.

A total of 562 patients were enrolled in this study. Three arms met the progression-free survival criteria to carry forward to phase III (standard of care, cediranib/olaparib, and cediranib). The median progression-free survivals were 3.4, 5.2, and 4 months with the standard of care, cediranib/olaparib, and cediranib, respectively. The median follow-up duration was 42.2 months. The progression-free survival hazard ratio estimates for cediranib/olaparib and cediranib vs the standard of care were 0.796 and 0.972, respectively. The median overall survivals were 13.6, 12.8, and 10.5 months, respectively. Of the 443 patients with measurable disease progression, the objective response rate was 8.6%, 24.7%, and 13.1% for the standard of care, cediranib/olaparib, and cediranib, respectively. The researchers reported no new safety signals.

Disclosure: For full disclosures of the study authors, visit ascopubs.org.

Journal of Clinical Oncology

---