Ovarian cancer: the addition of two targeted therapies delays the return of the disease

A reduction in the risk of having disease progression. This is the effect of adding two drugs to the standard of care for women who are diagnosed with advanced ovarian cancer and do not carry the BRCA mutation

Ovarian cancer: a silent killer

Ovarian cancer can develop in a sneaky way for many months before a woman realizes it. About half of patients diagnosed with ovarian cancer are 63 or older. Its symptoms (gynecological or digestive disorders or a feeling of heaviness in the abdomen) are not very specific, which increases the risk of “missing” the disease. An element that plays on the care and vital prognosis of affected patients.

We know that early detection is an incredible challenge: 70 to 90% of women whose ovarian cancer was detected at a primary stage are still alive 5 years after diagnosis compared to only 20 to 30% of those whose the cancer was diagnosed at an advanced stage 3. And unfortunately, the second scenario is more often encountered… Only 20% of all cases of ovarian cancer are detected at an early stage.

And despite various attempts, no early detection test is available today. This is a research challenge, just like that of better treating these advanced forms. In some patients, a BRCA mutation is detected and in this case, they can benefit from a targeted treatment, the leader of which is olaparib (Lynparza®) already marketed as monotherapy or associated with bevacizumab (a monoclonal antibody which enters in the standard treatment of ovarian cancer).

What treatment for advanced ovarian cancer?

In the study presented at the ASCO congress, 1130 patients with advanced ovarian cancer without BRCA mutation were divided into three groups:

• The first group received the standard treatment: chemotherapy and bevacizumab as treatment, then maintenance with bevacizumab;
• The second group received the same treatment plus durvalumab, for treatment and maintenance;
• The third group received in addition durvalumab like the 2nd group with in addition olaparib in maintenance.

Results :

The combination of Lynparza, Imfinzi, chemotherapy and bevacizumab reduced the risk of disease progression or death by 37% compared with standard treatment. The mean disease progression-free time (median PFS) was 24.2 months versus 19.3 months.

Among patients with a positive homologous recombination deficiency (HRD – characterized by genomic instability) status, the risk of disease progression or death was reduced by 51% compared to standard treatment. The median PFS was 37.3 months versus 23 months.

Side effects remain a point to monitor: nearly 65% ​​of patients in the third group continued the treatment until its end, against 80% in the first group.

Towards a new standard for advanced ovarian cancers

These results offer new hope for women with advanced, non-BRCA ovarian cancer, as confirmed by the study’s lead author.

“Although there have been significant advances for patients with advanced ovarian cancer, an unmet need remains. Our trial results provide encouraging evidence that we can find new treatment approaches for patients with advanced disease.“, said Prof. Philipp Harter, director of the department of gynecology and gynecological oncology at the Evangelische Kliniken Essen-Mitte hospital in Essen (Germany).

The results presented at this congress are intermediate results. The follow-up of the study will provide more solid data to confirm the benefit foreseen today and to request a possible marketing authorization in this indication.