Ovarian cancer, combination of therapies delays return of disease
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A reduction in the risk of having a disease progression. It is the effect of adding two drugs to the standard of care given to women who are diagnosed with advanced ovarian cancer and who do not have the BRCA mutation. “There is no method that allows you to detect this tumor in the early stages, so over two-thirds of patients are diagnosed when the disease is already serious, and often relapses. More research is definitely needed in this area, but the results of this study show that a new drug combination capable of prolonging disease-free survival may be considered a promising option for these patients,” said Merry Jennifer Markham, MD, MD and Asco expert.
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The combination
In the study, patients were divided into three groups: the first received standard therapy (composed of paclitaxel/carboplatin and bevacizumab, plus bevacizumab as maintenance) alone; the second also received durvalumab in addition both in the first phase of treatment and in the maintenance phase; compared to the second, the third also received olaparib as maintenance. The results demonstrate an improvement in disease-free survival in patients in the third group, especially those who have a defect in the ability to repair DNA called homologous recombination deficiency. The reduction in the risk of progression for these women is 51% and 37% for the whole group. “While significant progress has been made for advanced ovarian cancer, there are still many unmet needs. The results of our study are encouraging and show that new drugs can be found for these patients,” said Philipp Harter, director of the department of gynecology and gynecology oncology at the Evangelische Kliniken Essen-Mitte hospital in Essen, Germany.
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The illness
Ovarian cancer is the leading cause of death from gynecological cancer and the fifth from cancer in the female population in developed countries. Every year it is estimated that 65,000 cases are diagnosed in Europe, of which over 5,000 in Italy. Only 20% of cases are discovered in the early stages and, unfortunately, when the tumor is detected late, the probability of being alive 5 years after diagnosis is only 30%.
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The two more drugs
Durvalumab is an inhibitor of checkpioint, the class of immunotherapy drugs that has revolutionized the history of disease in the case of advanced melanoma, and olaparib is an inhibitor of PARP, a family of molecules that blocks a specific cellular repair mechanism. Two recent studies demonstrated the efficacy of olaparib maintenance therapy in patients with BRCA mutation and that of bevacizumab in patients with HRD, respectively. In this type of patient, where diseased cells have more difficulty repairing themselves, Parp inhibitors are more likely to be effective. Hence the idea of the researchers to use the new combination of bevacizumab and durvalumab with the addition of olaparib to see if it would increase the antitumor effect.
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