Novel Chemoimmunotherapy Regimen Under Study in Recurrent Ovarian Cancer
Posted: Thursday, December 17, 2020
The combination of pembrolizumab with bevacizumab and oral metronomic cyclophosphamide appears to be a tolerable treatment for patients with recurrent ovarian cancer, according to a study published in JAMA Oncology. Kunle Odunsi, MD, PhD, of Roswell Park Comprehensive Cancer Center, New York, and colleagues said further studies are underway to understand immune checkpoint inhibition, antiangiogenic therapy, and regulation T-cell depletion.
“This clinical trial represents a significant conceptual advance in the use of combination therapy to enhance the efficacy of immunity therapy, demonstrating that we can generate long-term disease control in ovarian cancer without compromising quality of life,” said Dr. Odunsi in a Roswell Park press release.
The authors enrolled 40 patients for an open-label, single-arm phase II cohort study from one institution in the United States. They were enrolled between September 2016 to June 2018, and eligible patients had recurrent ovarian cancer. A total of 30 women had platinum-resistant and 10 had platinum-sensitive ovarian cancer. The patients received intravenous pembrolizumab (200 mg) and bevacizumab (15 mg/kg) every 3 weeks and cyclophosphamide (50 mg) once daily until disease progression, severe toxicity or withdrawal.
Of the total, 3 women had complete responses, 16 had partial responses, and 19 had stable disease following therapy. The overall response rate was 47.5%; a clinical benefit was recorded in 38 patients, and a durable response was seen in 10 patients. The treatment showed a clinical benefit in 95% in 25% of patients. Hypertension and lymphopenia were the most common grade 3 to 4 treatment-related adverse events, and the most common reported events were fatigue, diarrhea, and hypertension.
“Approximately 30% of our patients were still living more than a year and a half after going on this combination, which we did not anticipate. These are very striking results,” commented study author Emese Zsiros, MD, PhD, FACO, also of Roswell Park.
Disclosure: The study authors’ disclosure information can be found at jamanetwork.com.