This transcript has been edited for clarity.
Hello. I'm Don Dizon. I direct the pelvic malignancies program at Lifespan Cancer Institute, and I am the associate director of community outreach and engagement at Legorreta Cancer Center at Brown University. I'm speaking from the 2024 American Society of Clinical Oncology (ASCO) Annual Meeting in Chicago, where we've seen some new, interesting data in gynecologic cancers.
I was privileged enough to talk about BrUOG 354, which was a randomized phase 2 trial looking at nivolumab as well as a combination of nivolumab with ipilimumab in people with ovarian or nonrenal clear cell cancers. The bottom line here that we were able to show is that immunotherapy is a very important and available option for treatment for people with clear cell cancers.
With nivolumab, the overall response rate was 14.3%. That included two partial responders among 15 people treated. That response rate with the combination went to 33%, including five complete responses in this population. Progression-free survival with single-agent nivolumab was 2 months, and overall survival was 17 months. With the combination, it was 6 months of progression-free survival and 24 months of overall survival.
Notably, we did see evidence that those who responded to combination therapy had durable responses. Nivolumab plus ipilimumab is a widely available combination that we believe is showing important activity for people with this relatively rare, very aggressive histology called clear cell.
In addition to that, data were presented from the AGO clinical trials group in Europe that looked at atezolizumab in combination with chemotherapy and bevacizumab vs chemotherapy plus bevacizumab plus placebo. The ultimate results from this trial were that atezolizumab did not prolong survival outcomes in the context of platinum-resistant ovarian cancer. There was a very nice distillation by Dr Bradley Corr, which indicates that single-agent immunotherapy probably does not play a role in the treatment of ovarian cancer.
Whether combination immunotherapeutic approaches are going to show an advantage in terms of surviving ovarian cancer is the next question that should be asked. Being very selective about who we want to further evaluate in terms of subgroups is also very important.
Another trial that was discussed looked at the contribution of chemotherapy to chemoradiation for people with locally advanced cervical cancer. This was a Radiation Therapy Oncology Group (RTOG) clinical trial where people got chemoradiation followed by carboplatin and paclitaxel. This ended up being the second trial that showed there was no benefit to postchemotherapy radiation plus chemotherapy consisting of carboplatin and paclitaxel. There was no survival advantage seen.
It mirrors the results of another trial called OUTBACK, which was presented about 3 or 4 years ago, and was also a negative trial. Dr Anuja Jhingran from MD Anderson concluded that there is no role for chemotherapy after chemoradiation. I think this is an important clinical trial that really does shut the door, potentially, on the role of chemotherapy after chemoradiation and moves us forward as we seek to perhaps maximize the benefits of radiation so that more people can access radiation globally in a more equitable way, for example.
Finally, there were some really nice data presented on a combination of a TIGIT inhibitor as well as pembrolizumab that suggest this is a very important novel combination in people with previously treated mismatch repair–deficient endometrial cancer. Again, the caveat there is that although the data looked very promising, there is a standard of care in place already, which is chemotherapy with pembrolizumab on the heels of two very important phase 3 trials that have already been published, RUBY and GY018.
Whether or not this plays a role or will replace them as standard of care, it takes far more follow-up as well as a large phase 3 clinical trial to prove that. But again, this is a very promising drug combination.
Thank you for joining me. This is Don Dizon, speaking from the 2024 ASCO Annual Meeting in Chicago.
COMMENTARY
ASCO 2024: Updates on Clinical Trials in Gynecologic Cancers
Don S. Dizon, MD
DISCLOSURES
| June 24, 2024This transcript has been edited for clarity.
Hello. I'm Don Dizon. I direct the pelvic malignancies program at Lifespan Cancer Institute, and I am the associate director of community outreach and engagement at Legorreta Cancer Center at Brown University. I'm speaking from the 2024 American Society of Clinical Oncology (ASCO) Annual Meeting in Chicago, where we've seen some new, interesting data in gynecologic cancers.
I was privileged enough to talk about BrUOG 354, which was a randomized phase 2 trial looking at nivolumab as well as a combination of nivolumab with ipilimumab in people with ovarian or nonrenal clear cell cancers. The bottom line here that we were able to show is that immunotherapy is a very important and available option for treatment for people with clear cell cancers.
With nivolumab, the overall response rate was 14.3%. That included two partial responders among 15 people treated. That response rate with the combination went to 33%, including five complete responses in this population. Progression-free survival with single-agent nivolumab was 2 months, and overall survival was 17 months. With the combination, it was 6 months of progression-free survival and 24 months of overall survival.
Notably, we did see evidence that those who responded to combination therapy had durable responses. Nivolumab plus ipilimumab is a widely available combination that we believe is showing important activity for people with this relatively rare, very aggressive histology called clear cell.
In addition to that, data were presented from the AGO clinical trials group in Europe that looked at atezolizumab in combination with chemotherapy and bevacizumab vs chemotherapy plus bevacizumab plus placebo. The ultimate results from this trial were that atezolizumab did not prolong survival outcomes in the context of platinum-resistant ovarian cancer. There was a very nice distillation by Dr Bradley Corr, which indicates that single-agent immunotherapy probably does not play a role in the treatment of ovarian cancer.
Whether combination immunotherapeutic approaches are going to show an advantage in terms of surviving ovarian cancer is the next question that should be asked. Being very selective about who we want to further evaluate in terms of subgroups is also very important.
Another trial that was discussed looked at the contribution of chemotherapy to chemoradiation for people with locally advanced cervical cancer. This was a Radiation Therapy Oncology Group (RTOG) clinical trial where people got chemoradiation followed by carboplatin and paclitaxel. This ended up being the second trial that showed there was no benefit to postchemotherapy radiation plus chemotherapy consisting of carboplatin and paclitaxel. There was no survival advantage seen.
It mirrors the results of another trial called OUTBACK, which was presented about 3 or 4 years ago, and was also a negative trial. Dr Anuja Jhingran from MD Anderson concluded that there is no role for chemotherapy after chemoradiation. I think this is an important clinical trial that really does shut the door, potentially, on the role of chemotherapy after chemoradiation and moves us forward as we seek to perhaps maximize the benefits of radiation so that more people can access radiation globally in a more equitable way, for example.
Finally, there were some really nice data presented on a combination of a TIGIT inhibitor as well as pembrolizumab that suggest this is a very important novel combination in people with previously treated mismatch repair–deficient endometrial cancer. Again, the caveat there is that although the data looked very promising, there is a standard of care in place already, which is chemotherapy with pembrolizumab on the heels of two very important phase 3 trials that have already been published, RUBY and GY018.
Whether or not this plays a role or will replace them as standard of care, it takes far more follow-up as well as a large phase 3 clinical trial to prove that. But again, this is a very promising drug combination.
Thank you for joining me. This is Don Dizon, speaking from the 2024 ASCO Annual Meeting in Chicago.
Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.
TOP PICKS FOR YOU