PracticeUpdate Oncology Best of 2018

ASCO 2018 25

Best in Ovarian Cancer By Annette Hasenburg Prof. Dr. med.

JCOG0602 and SCORPION Trials 5500 Comparison of survival between upfront primary debulking surgery versus neoadjuvant chemotherapy for stage III/IV ovarian, tubal and peritoneal cancers in phase III randomized trial: JCOG0602. T Onda, T Satoh, T Saito, et al 5516 Survival analyses from a randomized trial of primary debulking surgery versus neoadjuvant chemo- therapy for advanced epithelial ovarian cancer with high tumor load (SCORPION trial). A Fagotti, G Vizzielli, G Ferrandina, et al • Two phase III trials in ovarian cancer could not show superiority of neoadjuvant chemotherapy and interval debulking versus primary debulking surgery. Neoadjuvant chemotherapy was advantageous in women with a performance status of 2/3, serum albumin <2.5, and CA 125 >2000, and in institutions with low study activity. It was not an advantage in women with clear/mucinous histology, without sig- nificant differences. 2010–2013 National Cancer Data Base 5502 Outcomes and costs of open, robotic, and lap- aroscopic radical hysterectomy for stage IB1 cervical cancer. DJ Margul, J Yang, BL Seagle, et al • In patients with cervical cancer, laparoscopic or robotic surgery was associated with decreased morbidity and costs; however, women with a tumor size ≥2 cm who underwent minimal invasive rad- ical hysterectomy had significantly shorter survival compared with women who underwent open radical hysterectomy. GOG 218 5517 Final overall survival (OS) analysis of an interna- tional randomized trial evaluating bevacizumab (BEV) in the primary treatment of advanced ovarian cancer: A NRG oncology/Gynecologic Oncology Group (GOG) study. RA Burger, D Enserro, KS Tewari, et al • In front-line ovarian cancer therapy, there were no survival differences between patients receiving bevacizumab in combination with carboplatin and paclitaxel compared with patients receiving chemo- therapy alone. AGO-OVAR 16 5518 AGO-OVAR 16: A phase III study to evaluate the efficacy and safety of pazopanib (PZ) monotherapy ver- sus placebo in women who have not progressed after first line chemotherapy for epithelial ovarian, fallopian tube, or primary peritoneal cancer—Overall survival (OS) results. I Vergote, LC Hanker, A Floquet, et al • An anti-angiogenic strategy of maintenance therapy with pazopanib, an oral multikinase inhibitor of VEGFR and PDGFR, after first-line therapy in women with ovarian cancer did not show a consistent overall

survival benefit. Subpopulations may benefit (FIGO stage IV); however, there are also populations for whom there may be increased harm (East Asians). AGO-OVAR 11 5520 Significant overall survival improvement in pro- liferative subtype ovarian cancer patients receiving bevacizumab. S Kommoss, F Heitz, BJN Winterhoff, et al • In women with advanced ovarian cancer, only patients with tumors of the proliferative subtype had a statistically significant benefit from the addition of bevacizumab to standard chemotherapy, with a median improvement in progression-free survival of 10.2 months and a median improvement in overall survival of 17.2 months. GOG 213 5501 A phase III randomized controlled trial of sec- ondary surgical cytoreduction (SSC) followed by platinum-based combination chemotherapy (PBC), with or without bevacizumab (B) in platinum-sensitive, recurrent ovarian cancer (PSOC): A NRG Oncology/ Gynecologic Oncology Group (GOG) study. RL Cole- man, D Enserro, N Spirtos, et al • Cytoreduction in patients with recurrent ovarian cancer was not associated with an improvement in either overall or progression-free survival compared with no surgery. MITO-16 5506 Chemotherapy plus or minus bevacizumab for platinum-sensitive ovarian cancer patients recurring after a bevacizumab containing first line treatment: The randomized phase 3 trial MITO16B-MaNGO OV2B-EN- GOT OV17. S Pignata, D Lorusso, F Joly, et al • For patients with recurrent ovarian cancer pre- viously treated with bevacizumab in the first line relapsing ≥6 months after the last platinum treat- ment, rechallenge with bevacizumab in combination with platinum-based doublets was associated with a significantly prolonged progression-free survival, with no unexpected toxicity. QUADRA 5514 QUADRA: A phase 2, open-label, single-arm study to evaluate niraparib in patients (pts) with relapsed ovarian cancer (ROC) who have received ≥3 prior chemotherapy regimens. KN Moore, AA Secord, MA Geller, et al • Niraparib demonstrated durable anticancer activity with manageable toxicities in a heavily pretreated (≥ fourth line) population with recurrent ovarian cancer and HRD-positive, including BRCA wild-type, status.

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VOL. 2 • NO. 4 • 2018