PracticeUpdate: Oncology - Winter 2018

ASCO 2018 25

ASCO 2018: 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. 3 • 2018