Serous Ovarian Cancer: Paclitaxel Dosing Comparison From VELIA Trial
Posted: Wednesday, November 25, 2020
Using dose-dense weekly paclitaxel with a combination of carboplatin and veliparib appears to be associated with longer progression-free survival than paclitaxel dosed every 3 weeks in patients with newly diagnosed high-grade serous ovarian cancer, according to an exploratory analysis of the VELIA study. However, grade 3 and 4 hematologic toxicities were more frequent with weekly paclitaxel, reported Aikou Okamoto, MD, PhD, of the Jikei University School of Medicine, Tokyo, and colleagues during the European Society for Medical Oncology (ESMO) Virtual Congress 2020 (Abstract 818P).
In the phase III study, 1,132 evaluable patients received carboplatin, paclitaxel, and placebo followed by placebo maintenance; carboplatin, paclitaxel and veliparib followed by placebo; or carboplatin, paclitaxel, and veliparib followed by veliparib maintenance. Investigators chose between paclitaxel at 175 mg/m2 every 3 weeks or at 80 mg/m2 weekly. In the analysis, 52% of patients received dose-dense weekly paclitaxel, and 48% received paclitaxel every 3 weeks.
Overall, weekly paclitaxel was linked with a significantly longer progression-free survival compared with paclitaxel every 3 weeks (20.5 vs. 15.7 months, hazard ratio = 0.77). The improvement in progression-free survival was seen in biomarker-negative subgroups as well. Progression-free survival was improved with veliparib, carboplatin, and paclitaxel followed by maintenance veliparib compared with carboplatin and paclitaxel alone, regardless of the paclitaxel regimen.
As for safety, grade 3 and 4 adverse events were more frequent with weekly paclitaxel compared with paclitaxel every 3 weeks, with rates of 90% versus 63% with carboplatin and paclitaxel alone, 94% versus 80% with veliparib, carboplatin, and paclitaxel followed by placebo, and 94% versus 82% with veliparib, carboplatin, and paclitaxel followed by maintenance veliparib, respectively.
Disclosure: For full disclosure of the study authors, visit oncologypro.esmo.org.