Ovarian Cancer

On November 14, 2022, the FDA accelerated the approval of mirvetuximab soravtansine-gynx (Elahere; ImmunoGen), an intravenous folate receptor alpha (FRα)-directed antibody and microtubule inhibitor conjugate, for the treatment of adults with FRα-positive, platinum-resistant epithelial ovarian, fallopian tube, or primary peritoneal cancer after 1 to 3 previous systemic treatments, regardless of previous use of bevacizumab (Avastin). Patients should be identified for treatment with mirvetuximab soravtansine by an FDA-approved test.

Despite improvements in the treatment of advanced ovarian cancer, less than half of newly diagnosed patients survive longer than 5 years, and relapse rates remain high. At the Society of Gynecologic Oncology (SGO) 2021 Virtual Annual Meeting on Women’s Cancer, experts presented updated results from 2 phase 3 clinical trials showing the benefit of the poly (ADP-ribose) polymerase (PARP) inhibitors olaparib (Lynparza) and niraparib (Zejula) as maintenance therapy in women with advanced or recurrent disease.

With follow-up of more than 5 years, women with relapsed platinum-sensitive ovarian cancer and a BRCA mutation who participated in the multicenter phase 3 SOLO2 clinical trial lived more than 1 year longer when randomized to maintenance therapy with the poly (ADP- ribose) polymerase (PARP) inhibitor olaparib (Lynparza) compared with placebo, according to data released at the ASCO 2020 virtual annual meeting.

San Francisco, CA—Ovarian cancers with BRCA mutations are less immunogenic than other DNA repair–deficient tumors. Targeting the DNA damage response using PARP inhibitors may help to improve the modest responses of ovarian cancer seen with single-agent immune checkpoint inhibitors, said ­Panagiotis A. Konstantinopoulos, MD, PhD, Director of Translational Research, Division of Gynecologic Oncology, Dana-Farber Cancer Institute, Boston, at the 2019 ASCO-SITC Clinical Immuno-Oncology Symposium.

San Francisco, CA—Patients with ovarian cancer can respond to immunotherapy, but rationally designed synergistic combinations will be necessary to enhance upfront efficacy and to sustain durability, said Daniel J. Powell Jr, PhD, Scientific Director of Immunotherapy, Division of Gynecologic Oncology, Center for Cellular Immunotherapy, University of Pennsylvania, Philadelphia, at the 2019 ASCO-SITC Clinical Immuno-Oncology Symposium.

Patients receiving psychological support in the OVPSYCH2 randomized study showed reduced fear of progression compared with those without support.

Promising safety results from the CORAIL trial suggest a place for lurbinectedin in treating platinum-resistant ovarian cancer.

Durvalumab/PLD combination shows promising efficacy and a tolerable safety profile in women with platinum-resistant ovarian cancer.

Olaparib maintenance may prolong progression-free survival in patients, regardless of the number of previous platinum-based chemotherapies.