Tiffany Sia, MD, Provides Rationale for Exploring Interventions for Oligoprogressive Disease in Gynecologic Malignancies Treated With ICI

Tiffany Sia, MD, a gynecologic oncology fellow at Memorial Sloan Kettering Cancer Center in New York, spoke with CancerNetwork^® during the 2022 Annual Global Meeting of the International Gynecologic Cancer Society about patients with gynecologic malignancies who have oligoprogression during treatment with immune checkpoint inhibitors (ICI).

The study found a median progression-free survival of 9.0 months when patients were given long-term ICI vs 5.5 months when patients were given short-term treatment. Results were similar for median overall survival at 35.5 months and 21.6 months, respectively. The most common surgery performed for patients with oligoprogression occurring in 60% of patients was abdominal pelvic debulking.

Transcript:

The way that we came up with the idea for the study is that in our weekly treatment planning conference, we were seeing more and more patients with gynecologic cancers who were being treated with immunotherapy. They had good responses to immunotherapy, however in some cases, some patients had oligoprogression which is the increase in the size of 1 or 2 specific lesions within the body but with stable or responding lesions from other sites of the body. During these treatment planning conferences, we [wondered] what kind of treatment should we offer these patients. What if we perform a surgical resection? Can we do tumor-directed therapy, either via IR [interventional radiology] ablation or radiation therapy? Or should we just continue immunotherapy or other chemotherapies? That’s what led to this chart review and the basis of our study.

Between January 2013 and October 2021, we looked at all the patients within our institution who received immunotherapy for gynecologic malignancies. We found a total of 881 patients, and of these, we looked at every single procedure that the patients underwent between the start of immunotherapy and within 6 months of treatment completion. We only coded the patients that had undergone treatment for oligoprogression. There were 41 total procedures done for oligoprogressive disease within our cohort: 10 of these were surgical procedures, 3 patients underwent IR-guided ablation of their tumors, and there were 28 cases of radiation therapy.

Reference

Sia T, Wan V, Zivanovec O, et al. Procedural interventions for oligoprogression during treatment with immune checkpoint blockade in gynecologic malignancies. Presented at the Annual Global Meeting of the International Gynecologic Cancer Society; New York, NY; September 29-October 1, 2022. Poster FP014.