OVARIO phase II trial of combination niraparib plus bevacizumab maintenance therapy in advanced ovarian cancer following first-line platinum-based chemotherapy with bevacizumab

Author(s): Melissa M.Hardestya Thomas C.Krivakb Gail S.Wrightc ErikaHamiltond Evelyn L.Fleminge JimmyBelottef Erika K.Keetong PingWangf DivyaGuptaf AineClementsh Heidi J.Grayi Gottfried E.Konecnyj Richard G.Moorek Debra L.Richardsonl
Source: https://doi.org/10.1016/j.ygyno.2022.05.020
Gail Wright, MD, FACP, FCCP

FCS hematologist and medical oncologist Gail Wright, MD, FACP, FCCP co-authored a recent phase II study assessing the safety and efficacy of niraparib + bevacizumab as a first-line maintenance therapy for patients with newly diagnosed advanced ovarian cancer. The promising results found the majority to be progression-free in the first 18 months.

HIGHLIGHTS

  • OVARIO enrolled patients with primary advanced-stage ovarian cancer, including high-risk cases.
  • In the overall population, 62% of patients were progression-free at the 18-month primary endpoint.
  • After a median follow-up of 28.7 months, median PFS was 19.6 months (overall), 28.3 months (HRd), and 14.2 months (HRp).
  • The most common any-grade adverse events related to niraparib and/or bevacizumab were thrombocytopenia, fatigue, and anemia.

ABSTRACT

OBJECTIVE

To assess safety and efficacy of niraparib + bevacizumab as a first-line maintenance therapy for patients with newly diagnosed advanced ovarian cancer.

METHODS

This multicenter, phase II, single-arm, open-label study enrolled adult patients with stage IIIB to IV ovarian, fallopian tube, or primary peritoneal cancer (NCT03326193). Patients were required to have an attempt at debulking surgery and have a complete response, partial response, or no evidence of disease following first-line, platinum-based chemotherapy with ≥3 cycles of bevacizumab. The primary endpoint was the progression-free survival (PFS) rate at 18 months. Secondary endpoints included PFS, overall survival, and safety.

RESULTS

Among the 105 evaluable patients, the PFS rate at 18 months was 62% (95% CI 52–71%) in the overall population and 76% (95% CI 61–87) in the homologous recombination deficient (HRd), 47% (95% CI 31–64%) in the HR proficient (HRp), and 56% (95% CI 31–79%) in the HR not determined (HRnd) subgroups (December 24, 2020, cutoff). After a median follow-up time of 28.7 months (IQR, 23.9–32.5 months), median PFS was 19.6 months (95% CI 16.5–25.1) in the overall population (N = 105) and 28.3 months (95% CI 19.9–NE), 14.2 months (95% CI 8.6–16.8), and 12.1 months (95% CI 8.0–NE) in the HRd, HRp, and HRnd subgroups, respectively (June 16, 2021, cutoff). The most common any-grade treatment-related adverse events (related to niraparib and/or bevacizumab) were thrombocytopenia (74/105), fatigue (60/105), and anemia (55/105; December 24, 2020, cutoff).

CONCLUSION

Niraparib + bevacizumab first-line maintenance therapy displayed promising PFS results. Safety was consistent with the known safety profiles of niraparib and bevacizumab as monotherapy.

Author Affiliations

a Alaska Women’s Cancer Care, Anchorage, AK, USA b Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, The Western Pennsylvania Hospital, Pittsburgh, PA, USA c Florida Cancer Specialists and Research Institute, New Port Richey, FL, USA d Medical Oncology, Sarah Cannon Research Institute, Tennessee Oncology, Nashville, TN, USAe Division of Gynecologic Oncology, Norris Cotton Cancer Center, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA f GlaxoSmithKline, Waltham, MA, USA g GlaxoSmithKline, Waltham, MA, USA at the time the analysis was conducted h Department of Gynecologic Oncology, Riverside Methodist Hospital, Columbus, OH, USAi Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Washington, Seattle, WA, USA j University of California, Los Angeles, Los Angeles, CA, USAk Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, USA l Division of Gynecologic Oncology, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA

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