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2025 American Society of Clinical Oncology (ASCO) Annual Meeting,

 spoke with a variety of oncology experts about the late-breaking abstracts, plenary sessions, and other key presentations that may shift the paradigm across different cancer care fields. They highlighted anticipated clinical trial results that may transform the standard of care for gynecologic malignancies, lung cancer, and other disease types.

Rachel N. Grisham, MD, section head of Ovarian Cancer and director of gynecologic medical oncology at Memorial Sloan Kettering Westchester in New York, shared her anticipation of findings from the phase 3 ROSELLA trial (NCT05257408) assessing relacorilant plus nab-paclitaxel in patients with platinum-resistant ovarian cancer. She stated she was excited to see whether the data may represent a new opportunity for this patient population.

Next, MinhTri Nguyen, MD, a medical oncologist and hematologist at Stanford Health Care in San Jose, California, highlighted a few breast cancer presentations to look out for. These topics included a plenary session on data from the phase 3 SERENA-6 study (NCT04964934) evaluating camizestrant in combination with CDK4/6 inhibitors for patients with hormone receptor–positive, HER2-negative advanced breast cancer harboring emergent 

Additionally, Eric K. Singhi, MD, an assistant professor in the Department of General Oncology in the Division of Cancer Medicine, and assistant professor in the Department of Thoracic/Head and Neck Medical Oncology at The University of Texas MD Anderson Cancer Center in Houston, spoke about a range of potentially practice-changing results in the lung cancer field. For example, he described a session focused on primary results of the phase 3 IMforte trial (NCT05091567) assessing lurbinectedin (Zepzelca) plus atezolizumab (Tecentriq) for patients with extensive-stage small cell lung cancer. According to Singhi, data from IMforte may shift the paradigm of maintenance therapy for this population.

In the world of head and neck cancer, Douglas R. Adkins, MD, associate professor of Internal Medicine, Division of Oncology, Section of Medical Oncology at Washington University Medicine in St Louis, Missouri, highlighted the session on the phase 3 NIVOPOSTOP GORTEC 2018-01 trial (NCT03576417). Investigators evaluated nivolumab (Opdivo) in combination with chemoradiotherapy for those with resected head and neck squamous cell carcinoma. Adkins is eager to see how these data may impact the standard of care, particularly for patients in Europe, where investigators conducted the study.

discussion, Benjamin Garmezy, MD,  associate director of genitourinary research and executive cochair of the Genitourinary Cancer Research Executive Committee at Sarah Cannon Research Institute (SCRI) and a medical oncologist at SCRI Oncology Partners in Nashville, Tennessee, discussed key abstracts in bladder cancer. One specific presentation included additional findings from the phase 3 NIAGARA trial (NCT03732677), which may show how circulating tumor DNA can influence treatment decision-making regarding perioperative durvalumab (Imfinzi) for patients with muscle-invasive bladder cancer.

Experts in gynecologic cancer, genitourinary malignancies, and other disciplines highlight noteworthy clinical data slated for presentation at ASCO 2025.

Spotlighting Key Upcoming Presentations Across Oncology at ASCO 2025

Molecular differences in the profiles of low grade serous ovarian cancer (LGSOC) and high-grade SOC substantiate the need to find unique, differentiated treatment options for each epithelial ovarian cancer subtype, according to Kathleen N. Moore, MD, MS.

CancerNetwork® spoke with Moore, Virginia Kerley Cade Endowed Chair of Cancer Development, associate director of Clinical Research at the Stephenson Cancer Center, director of the Oklahoma TSET Phase I Program and professor in the Section of Gynecologic Oncology the University of Oklahoma Health Sciences Center, about distinguishing low grade serous ovarian cancer from other types of ovarian cancer, current treatment options and clinical trials evaluating new regimens, as well as managing treatment in younger patients with or those seeking to preserve fertility.

Moore began by differentiating LGSOC from high grade SOC, stating that this disease typically occurred in younger patients and was primarily characterized by MAP kinase alterations, specifically 

mutations. She then discussed the emergence of endocrine therapies in this indication owing to the presence of estrogen receptors.

Additionally, first line treatment was discussed, with the standard of care defined by primary cytoreduction followed by paclitaxel and carboplatin. She then highlighted multiple clinical trials assessing alternative treatment in this indication, particularly involving the use of letrozole (Femara).

Other clinical trials evaluated the use of CDK4/6 inhibition plus fulvestrant or 

 inhibition with letrozole, with Moore emphasizing the potential for these studies to shift the treatment paradigm in the frontline setting. Furthermore, she suggested that CDK4/6 inhibition may help enhance responses in patients with recurrent LGSOC.

Moore then highlighted treatment concerns for younger patients and those seeking to preserve fertility, while expressing the importance of understanding a patient’s goals, which may help optimize outcomes. She concluded by reiterating the importance of designing trials and tailoring treatment considering the molecular profile of LGSOC.

Foundation for Women’s Cancer

Low grade serous ovarian cancer, a rare epithelial ovarian cancer subtype, requires differentiated treatment from its high-grade counterpart.

Redefining the Treatment Paradigm in Low Grade Serous Ovarian Cancer

CancerNetwork® spoke with John Paul Diaz, MD, about uterine transposition, a surgical technique aiming to preserve fertility in women undergoing radiotherapy for pelvic tumors. Diaz is the chief of gynecologic oncology, director of robotic surgery, director of the Center of Excellence in Minimally Invasive Gynecologic Surgery at Baptist Health, and lead physician for Clinical Trials in Gynecologic Oncology at Miami Cancer Institute.

Of note, Diaz discussed the outcomes associated with 2 procedures conducted at his practice, as well as challenges associated with the development and implementation of the procedure. Additionally, he spoke about the next steps in developing and raising awareness of the procedure.

Diaz foregrounded the discussion by highlighting the simplicity of the procedure, which he stated was similar to a hysterectomy. Unlike a hysterectomy, uterine transposition entails a temporary relocation of the uterus to the anterior abdominal wall, which preserves it for fertility while removing it from the radiation field.

Furthermore, Diaz described the collaboration between Baptist Health and Memorial Sloan Kettering Cancer Center, including a partnership with Mario M. Leitao, Jr., MD, FACOG, FACS, who holds the largest series in the United States in performing uterine transpositions. He explained that the collaboration was conducive for expanding patient populations that may benefit from this surgery.

Diaz then underlined outcomes related to 2 uterine transposition procedures he conducted at Baptist Health. He described a favorable outcome with one patient who had completed the procedure 3 months prior who may be able to become pregnant in the future. The second patient was undergoing radiotherapy, with plans to undergo the second stage of the surgery in following months.

Diaz then highlighted a distinction between uterine transposition and other fertility preservation measures in that it preserves the entire uterus so patients can still carry a child, whereas other radiation therapy techniques do not. He then highlighted patients who are eligible for this procedure, particularly among women who want to preserve their fertility with pelvic tumors requiring radiation that might otherwise sterilize the uterus.

Challenges related to the development and implementation of the procedure were discussed, with particular emphasis placed upon quality of life following treatment. Additionally, he emphasized the idea of patient-driven improvements in treatment outcomes, which he hoped could be applied to help more women preserve their fertility.

Diaz continued by emphasizing the novelty of the procedure, explaining that experiences with it are growing while surgery success rates increase with global collaboration and technique sharing. He followed by underscoring the primary goal of cancer eradication, stressing that treatment for progressing disease takes precedence over fertility, and in those situations, fertility may be compromised.

He further outlined key short-term outcomes in patients undergoing uterine transposition, particularly as they related to maintaining uterine perfusion and mitigating post-operative complications. For long-term outcomes, he highlighted the goal for patients to be disease-free and capable of carrying a live birth.

Additionally, Diaz underscored a challenge related to raising awareness for this procedure, highlighting efforts he has undertaken to inform surgeons in the colorectal cancer field about the availability of this procedure as an option for this patient population. He suggested that colleague identification of eligible patients, effective referral, and increased proliferation of procedure knowledge may be effective in overcoming this challenge.

Diaz concluded by highlighting next steps for the procedure as they relate to expanding access for patients, increasing knowledge of the procedure among physicians, and developing novel techniques for uterine preservation during radiotherapy. He highlighted the “exciting” development of this procedure, which he suggested might have been inconceivable a few years ago, in achieving better outcomes for young women diagnosed with pelvic tumors.

Uterine transposition, a surgical approach preserving fertility by moving the uterus out of the radiation field, may improve gynecologic cancer outcomes.

Uterine Transposition May Maintain Fertility Following Pelvic Radiotherapy

, Ginger J. Gardner, MD, FACOG, spoke about current research and advocacy efforts to improve clinical outcomes among patients with gynecological cancers. With diagnoses of gynecologic malignancies on the rise around the world, Gardner also highlighted the next steps for raising awareness in the field and addressing gaps in care.

Gardner is a gynecologic surgeon at Memorial Sloan Kettering Cancer Center, as well as the chair of the board for the Foundation for Women's Cancer (FWC).

According to Gardner, approximately 115,000 of those in the United States and 1 million patients across the world are diagnosed with gynecologic cancer. Additionally, she highlighted a growing incidence of uterine cancers, which included a 2-fold increase in mortality among patients who are Black in the United States compared with other populations.

As part of raising awareness in this patient population and advancing potential therapeutic solutions, Gardner described ongoing initiatives at FWC to facilitate collaboration among scientists, researchers, and gynecologic oncology providers to help improve outcomes. Regarding potential treatment innovations, she also highlighted clinical trials designed to assess various disease prevention methods and other therapies like targeted agents, PARP inhibitors, and antiangiogenic treatments.

Looking ahead, Gardner detailed other potential developments in the gynecologic cancer space that she is excited about. For example, she spoke about future efforts to further uncover the tumor biology and molecular heterogeneity associated with these malignancies, which may help providers optimize treatment plans for patients.

“We are seeing some impact in improvement for gynecologic cancers with innovation in many of our disciplines; that includes disease prevention and innovative modalities related to treatment, inclusive of surgical innovation, new targeted therapies, refining radiation treatment, and ultimately patient-reported outcomes. We need to keep our eye on the ball for where we’re going next,” Gardner stated. “It is hard to dial it into just 1 or 2 snapshots, but I am so thankful that we have this time together to talk about the importance of gynecologic health awareness and research because it is important that we raise this conversation.”

Ginger J. Gardner, MD, FACOG, highlights disease prevention innovations and other ongoing efforts to empower education in the gynecologic cancer field.

Empowering Awareness to Address Rising Gynecological Cancer Incidence

FDA approval of pembrolizumab (Keytruda) plus chemoradiotherapy

in FIGO stage III to IVA cervical cancer, Jyoti S. Mayadev, MD, spoke about how the regimen’s approval would be a “major step” for the aforementioned population and how she planned to integrate it into her care.

Mayadev, a board-certified radiation oncologist and professor of radiation medicine and applied sciences at the University of California, San Diego School of Medicine, stated that the approval would be a “huge win” with respect to progression-free survival (PFS) based on supporting findings from the 

2023 Annual Global Meeting of the International Gynecologic Cancer Society (IGCS),

treatment with pembrolizumab plus chemoradiotherapy produced a significant PFS benefit compared with chemoradiation alone (HR, 0.70; 95% CI, 0.55-0.89; 

 Additionally, findings from a subgroup analysis highlighted that the PFS benefit with the pembrolizumab-based combination extended to those with FIGO stage III to IVA disease (HR, 0.58; 95% CI, 0.42-0.80).

Mayadev also described the tolerability and quality-of-life benefits associated with the pembrolizumab combination in the KEYNOTE-A18 trial. Additionally, she stated that potential next steps for research may involve integrating adaptive technology to potentially reduce toxicity following chemoradiation among patients with cervical cancer.

“Uptake of any new agent requires a multidisciplinary team approach. It requires workflows,” Mayadev said regarding her strategy for adopting the newly approved regimen in her clinic. “For our particular institution, we would somewhat seamlessly go into the FDA approval. At the same time, we would try to help others in the community. We, as a scientific global community for gynecologic oncology and radiation oncology, will come together and start to incorporate how we can move forward with the FDA approval.”

FDA approves pembrolizumab with chemoradiotherapy for FIGO 2014 stage III-IVA cervical cancer. News release. January 12, 2024. Accessed January 15, 2024. https://bit.ly/3NZNGPb

Lorusso D, Xiang Y, Hasegawa K, et al. ENGOT-cx11/GOG-3047/KEYNOTE-A18: A randomized, double-blind, phase 3 study of pembrolizumab plus chemoradiotherapy for high-risk locally advanced cervical cancer. Presented at 2023 Annual Global Meeting of the International Gynecologic Cancer Society; November 5-7, 2023; Seoul, South Korea. Abstract SE004/1614.

The FDA approval of pembrolizumab plus chemoradiation benefits patients with stage III to IVA cervical cancer based on findings from the KEYNOTE-A18 trial, according to Jyoti S. Mayadev, MD.

Jyoti S. Mayadev, MD, on Pembrolizumab/CRT FDA Approval in Cervical Cancer

 spoke with experts across multiple disciplines about the far-reaching impacts of the ongoing shortages of chemotherapy drugs including carboplatin and cisplatin, and how practices may be able to mitigate these challenges in the short and long term.

Michael Ganio, PharmD, MS, BCPS, FASHP, described the causes of carboplatin and cisplatin being in short supply across the United States and how the FDA is working with Chinese manufacturers to import these chemotherapy agents. Ganio, senior director of Pharmacy Practice and Quality at the American Society of Health-System Pharmacists, stated that communication is paramount among all members of a care team to help prevent critical errors while treating patients with limited supplies of these drugs. He also spoke about how reaching out to local representatives may help address the issues resulting from these shortages.

“Advocacy is needed,” Ganio said. “Our policymakers need to know that these shortages are having a real-world impact, and that they need to be addressed.”

Brian Slomovitz, MD, MS, FACOG, spoke about how he is managing the ongoing shortages in the context of his gynecologic cancer care, including swapping one platinum-based drug for another during treatment. Slomovitz, a gynecologic oncologist, director of Gynecologic Oncology, and co-chair of the Cancer Research Committee at Mount Sinai Medical Center in Miami Beach, Florida and a professor of Obstetrics and Gynecology at Florida International University, also described the challenges many practices across the country have due to lacking platinum-based drugs altogether.

“I know there are institutions that don't have [platinum-based chemotherapy],” Slomovitz said. “There are institutions that aren't able to give their patients the best standard-of-care therapy and aren't able to enroll patients in trials because of lack of therapy.”

Lucio N. Gordan, MD, addressed the financial impacts of these shortages, discussing how his practice has managed the rising prices of carboplatin and cisplatin in the country. Gordan, president and managing physician at Florida Cancer Specialists & Research Institute who sees patients in the state-wide practice's Gainesville Cancer Center, stated that efforts from major oncology organizations may help increase adequate access to chemotherapy drugs.

“It's very important that the large practices and institutions in the country stay united,” Gordan said. “The Community Oncology Alliance [COA], American Society of Clinical Oncology [ASCO], and others are trying to push legislation that would protect the consumer, the patients, and us to make sure that we have a proven supply.”

Don’t forget to subscribe to the “Oncology On-The-Go” podcast on 

Temporary importation of CISplatin injection with non-U.S. labeling to address drug shortage. FDA. May 24, 2023. Accessed September 13, 2023. https://shorturl.at/eiPQZ

Pharmaceutical, gynecologic oncology, and physician perspectives shed light on potentially mitigating the ongoing carboplatin and cisplatin shortages’ effects on cancer care in the United States.

Navigating the Impact of Chemotherapy Shortages on Cancer Care and Finances

Ritu Salani, MD, and Tanios S. Bekaii-Saab, MD, FACP, spoke with CancerNetwork

2023 American Society of Clinical Oncology (ASCO) Annual Meeting

, and how they may affect clinical practice for gynecologic cancer and gastrointestinal cancer.

Salani, the Gynecologic Oncology Fellowship Director at University of California Los Angeles (UCLA) Health and the Gynecologic Oncology editorial board member for the journal ONCOLOGY

, discussed presentations on the treatment of ovarian cancer and other gynecologic malignancies. These included data on dostarlimab-gxly (Jemperli) in advanced or recurrent endometrial cancer in the 

mirvetuximab soravtansine-gynx (Elahere) in folate receptor alpha–high platinum-resistant ovarian cancer in the 

 and a bevacizumab (Avastin)-based regimen in newly diagnosed ovarian cancer in the 

Bekaii-Saab, leader of the Gastrointestinal Cancer Program at the Mayo Clinic Comprehensive Cancer Center; medical director of the Cancer Clinical Research Office; vice chair/section chief for Medical Oncology, Department of Internal Medicine, at Mayo Clinic, Phoenix, Arizona; and the Gastrointestinal Cancer chair for the ONCOLOGY

 tumor board, detailed findings from presentations in the gastrointestinal cancer space. He discussed data on fam-trastuzumab deruxtecan-nxki (Enhertu) in HER2-positive metastatic colorectal cancer (CRC) in the 

phase 2 DESTINY-CRC02 study (NCT04744831),

 sotorasib (Lumakras) in advanced solid tumors with 

G12C mutations in the phase 1b/2 CodeBreaK 101 trial (NCT04185883), and bevacizumab plus atezolizumab (Tecentriq) in metastatic CRC in the phase 2 AtezoTRIBE trial (NCT03721653).

American Society of Clinical Oncology Annual Meeting (ASCO)

Experts from University of California, Los Angeles Health and Mayo Clinic discuss key data presented at the 2023 American Society of Clinical Oncology (ASCO) Annual Meeting in the gynecologic and gastrointestinal cancer spaces and how they may impact patient care.

Oncology On-The-Go Podcast: ASCO 2023 Recap

In a Twitter Spaces edition of the Oncology On-The-Go podcast, Ritu Salani, MD, and Dana Chase, MD, spoke with CancerNetwork

Society of Gynecologic Oncology (SGO) 2023 Annual Meeting on Women’s Cancer,

 and how they may impact clinical practice.

, and Chase, associate professor of UCLA Obstetrics and Gynecology in the Division of Gynecologic Oncology, reviewed data from trials including the 

phase 3 ENGOT-OV16/NOVA study (NCT01847274).

Society of Gynecologic Oncology Annual Meeting on Women’s Cancer (SGO)

Experts from UCLA Health discuss key data presented at The Society of Gynecologic Oncology 2023 Annual Meeting on Women’s Cancer and how they may apply to clinical practice.

Oncology On-The-Go Podcast: SGO 2023 Recap

 Biennial Ovarian Cancer Research Symposium, being held September 13–15 at the University of Washington in Seattle, we are speaking with Dr. Dmitriy Zamarin, MD, PhD, a medical oncologist who specializes in the care and treatment of women with cervical, ovarian, and other gynecological cancers at the Memorial Sloan Kettering Cancer Center in New York City. At the conference, Dr. Zamarin presented data from a phase II trial at Memorial Sloan Kettering, of a peptide vaccine called TPIV-200 in combination with durvalumab, an anti–PD-1 checkpoint inhibitor antibody, in patients with platinum-resistant ovarian cancer. 

Can you first describe this peptide vaccine, what it targets, and the rationale for its use as a therapy for advanced ovarian cancer?

 Absolutely. One of the limitations of cancer vaccines against shared antigens in different cancers in general is that the overexpression of some of these antigens is restricted to only a subset of tumors. The nice thing about the vaccine against the folate receptor alpha that we are using is that folate receptor alpha is overexpressed in the majority of ovarian cancers. In the metastatic setting, it has been reported that 80% or more of these tumors express folate receptor alpha. In addition, spontaneous immunity against the folate receptor alpha has been previously reported in breast and ovarian cancer patients which suggests that this target can actually be immunogenic.

 suggested that folate receptor alpha is an attractive target for vaccination and generated the rationale for this vaccine. In this case, the vaccine is called TPIV-200 and is composed of five long peptides that each target different regions of the folate receptor alpha. Those specific peptides were previously identified to elicit T-cell responses in breast and ovarian cancer patients that were vaccinated with this product.

These peptides are HLA Class II restricted, which means that there is not much of a restriction of use in specific patients as its estimated that over 85% of women express the HLA that would recognize at least one of these peptides and that eliminates the need to screen for specific HLA expression in the patients to assess their eligibility. In addition, the vaccine includes GM-CSF as an adjuvant to stimulate dendritic cells.

It sounds like this is not the first clinical trial to use this vaccine. Can you tell us about the design of this trial and also the rationale for combining these two immunotherapy approaches in ovarian cancer?

Sure. And you are absolutely right, this is not the first trial to use this vaccine. It has been previously tested for immunogenicity in breast and ovarian cancer patients. That study was not designed to look for outcomes, it was designed to test whether patients respond to this vaccine or not. And in that that study, which was published in 

a few months ago, vaccination had elicited T-cell responses in virtually every single patient that received the product. This was one of the findings that led us to try this vaccine in patients with advanced ovarian cancer.

That leads me to the design of this trial. Studies with various vaccines in cancer to data have, unfortunately, demonstrated rather underwhelming efficacy results. This is due to the fact that even once tumor-antigen specific T cells are generated via vaccination, these T cells might not be effective in clearing the tumor because of the multiple inhibitor–mechanisms that are present in the tumor microenvironment.

To overcome these mechanisms, there has been development of novel immunotherapy agents over the last few years including immune checkpoint blockade antibodies with those that target PD-1 or PD-L1 being the prime examples. While in some cancer types, such as melanoma, these antibodies are effective as single agents, in ovarian cancer, these anti-PD1 and anti-PDL1 antibodies have unfortunately not been very effective. Only about 10% of ovarian cancer patients respond to these drugs. Studies in animal models have indicated that combinations of tumor vaccines with agents targeting PD1 or PD-L1 can be very effective in instances when single agents don’t work.

In this trial, we decided to use a combination of this folate receptor alpha targeting vaccine and an agent targeting PD1, an antibody called durvalumab. This was a phase II study using a 2-stage design with 27 patients accrued to the first stage and then another 13 patients accrued to the second stage. The decision to proceed to the second stage was based on the response rate in the first stage.

We reported results on the first stage of the trial. This was a very heavily pre-treated patient population who received a median of four prior lines of chemotherapy and 33% of the patients received five or more lines of prior therapy. To provide a historical perspective, patients with platinum-resistant disease and two prior lines of therapy have a median overall survival of approximately 12 months, so ours is a much more heavily pre-treated population in this trial.

What are the key efficacy and safety results from this trial?

To start with the safety, this combination treatment was very well tolerated. The majority of the adverse events that were seen on the study were grade I or II and the most common adverse event was a grade I injection site reaction from the vaccine. This was seen in approximately 40% of the patients. Interestingly, this injection site reaction persisted for a long time, even after discontinuation of the vaccination which was probably reflective of an ongoing response to the vaccine. There were only two grade III/IV immune adverse events that were thought to be clinically significant.

One of the patients developed an immune-related thrombocytopenia and a second patient developed type I diabetes. But overall, the treatments were very well tolerated. With regards to the efficacy results, only 1 patient met the criteria for a partial response and 7 patients or 26% exhibited stable disease. Interestingly, several patients had pretty durable disease stabilization with 22% of patients being on the study beyond 24 weeks.

Based on these findings, the study was closed after the first 27 patients because it did not meet the criteria for the response rate that was needed to activate stage II of the study and the number of patients that benefited was, unfortunately, not higher than what would be expected for those patients treated with an anti-PD1 or anti-PD-L1 antibody alone.

Dr. Dmitriy Zamarin speaks with Cancer Network about the findings of a phase II trial in platinum-resistant ovarian cancer patients.

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