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Dr Annette Hasenburg discusses
key trials presented at ASCO 2016 on
gynaecological cancers
Annette Hasenburg,
Prof. Dr. med, is the
Director of Obstetrics
and Gynecology at Mainz
University Medical Center
in Mainz, Germany. She is
Head of the European
Society of Gynaecologic
Oncology Task Force
Psycho-Oncology,
and is on the board of
directors of the Institute
of Sexuality and Health of
the University Freiburg in
Freiburg, Germany.
Hormonal maintenance therapy for women with low
grade serous carcinoma of the ovary or peritoneum.
DM Gershenson, DC Bodurka, RL Coleman, et al
•
In a retrospective study, investigators evaluated the
effect of hormonal maintenance therapy (HMT)
versus surveillance following primary treatment
in 180 patients with stage II–IV low-grade serous
carcinoma of the ovary or peritoneum. Compared
with surveillance, HMT significantly increased
progression-free survival (52.0 months vs 29.9
months; P = 0.001) and reduced the risk of
recurrence (HR, 0.21; P < 0.001).
•
HMT may present an option in women with this
subtype of relatively chemo-resistant tumours.
Additional prospective studies are warranted.
Overall survival in patients with platinum-sensitive
relapsed serous ovarian cancer receiving olaparib
maintenance monotherapy: An interim analysis.
JA Ledermann, P Harter, C Gourley, et al
•
In this interim analysis (77% maturity) of a
phase 2 study, investigators evaluated the effect
of maintenance monotherapy with olaparib,
a PARP inhibitor, in patients with platinum-
sensitive relapsed serous ovarian cancer. Olaparib,
compared with placebo, increased overall survival
(29.8 vs 27.8 months; HR, 0.73); the benefit of
was greater in patients with a BRCA1/2 mutation
(34.9 vs 30.2 months; HR, 0.62).
•
Maintenance therapy with olaparib after a
response to platinum therapy provides an overall
survival advantage in patients with serous ovarian
cancer.
Phase II study of everolimus, letrozole, and metformin
in women with advanced/recurrent endometrial
cancer.
PT Soliman, SN Westin, DA Iglesias, et al
•
In this phase 2 study, the efficacy of everolimus,
letrozole, and metformin combination therapy
was assessed in 48 evaluable patients with
advanced/recurrent endometrial cancer.
•
The clinical benefit rate was 66.7%; this was not
affected by KRAS mutation status.
Baseline quality of life as a predictor of stopping
chemotherapy early, and of overall survival,
in platinum-resistant/refractory ovarian cancer: The
GCIG symptombenefit study.
F Roncolato, R O’Connell,
L Buizen, et al
•
Investigators evaluated 545 patients with
platinum-resistant/refractory ovarian cancer
to identify baseline quality-of-life domains
associated with premature termination of
palliative chemotherapy. Physical function, role
function, global health status, and abdominal/
GI symptoms were shown to be independent
predictors for overall survival (all P < 0.001). The
same QOL domains were significantly associated
with stopping chemotherapy within 8 weeks (all
P < 0.007).
•
QOL evaluation can help identify patients with
platinum-resistant/refractory ovarian cancer
who are unlikely to benefit from palliative
chemotherapy.
Pembrolizumab in patients with advanced cervical
squamous cell cancer: Preliminary results from
the phase Ib KEYNOTE-028 study.
J-S Frenel, C Le
Tourneau, BH O’Neil, et al
•
In this phase IB trial, 24 patients with PD-L1-
positive advanced cervical squamous cell cancer
received pembrolizumab, an anti-PD-1 antibody.
Partial responses were observed in 3 patients
(12.5%), with a median duration of response of
19.3 weeks. Stable disease occurred in 3 patients
(12.5%), with a median duration of 19.6 weeks.
The 6-month progression-free survival rate was
13.0% and the 6-month overall survival rate
was 66.7%. Treatment-related adverse events
were experienced by 18 patients (75%), with
the most common being pyrexia and rash.
Grade 3 treatment-related adverse events were
experienced by 5 patients (20.8%).
•
The investigators concluded that pembrolizumab
shows promising antitumour activity and was
well-tolerated in patients with PD-L1-positive
advanced cervical cancer.
Tumor-infiltrating lymphocytes (TILs) and PDL1
expression in ovarian cancer (OC): Evolution with
neoadjuvant chemotherapy (NCT) and prognostic
value.
S Mesnage, C Genestie, A Auguste, et al
•
In a retrospective study, investigators evaluated
the levels of tumour-infiltrating lymphocytes
(TILs) and PD-L1 expression in ovarian
cancer samples from 113 patients treated with
neoadjuvant chemotherapy. They found that 22%
of tumours had high levels of stromal TILs prior to
neoadjuvant chemotherapy. In 52% of evaluable
paired samples (n = 83), stromal TILs were
elevated following neoadjuvant chemotherapy.
In paired samples where PD-L1 was evaluable
(n = 27), 30% of tumours were PD-L1-positive
prior to neoadjuvant chemotherapy and 63%
were PD-L1-positive following. High levels
of stromal TILs were an independent positive
prognostic factor (HR, 0.49; P = 0.02).
AMERICAN SOCIETY OF CLINICAL ONCOLOGY 2016 ANNUAL MEETING
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PRACTICEUPDATE HAEMATOLOGY & ONCOLOGY