ESMO 2019 — Overview of Presidential Symposium I: ovarian and lung cancer


  • Ben Gallarda
  • Oncology Conference reports
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The first Presidential Symposium of ESMO 2019 highlighted improved outcomes with PARP inhibition in ovarian cancer, combination immunotherapy in NSCLC, and a third-generation EGFR-TKI in NSCLC.

Takeaway

Niraparib monotherapy in ovarian cancer after first-line chemotherapy:

  • Patients with homologous recombination deficiency (HRD) saw a median PFS of 21.9 vs 10.4 months with placebo (HR 0.43).
  • Similar benefits were seen in HRD patients with and without BRCA mutations (BRCAm).
  • Full coverage on Univadis.

Olaparib plus bevacizumab as maintenance therapy in ovarian cancer:

  • Improvement in median PFS was seen in the overall population (22.1 vs 16.6 months, HR 0.59), and was even greater in BRCAm (HR 0.31) and HRD (HR 0.33) subgroups.
  • PARP inhibition could move beyond BRCA mutations and raises the question of HRD testing in ovarian cancer.
  • Full coverage on Univadis.

Veliparib with front-line chemotherapy and maintenance in high-grade serous carcinoma of ovarian, fallopian tube, or primary peritoneal origin:

  • Three-tiered median PFS analysis showed benefit across subgroups: BRCAm 34.7 vs 22.0 months (HR 0.44); HRD 31.9 vs 20.5 (HR 0.57); intent-to-treat 23.5 vs 17.3 months (HR 0.68)
  • Interim analysis of veliparib only during chemotherapy showed similar results as also continuing with maintenance phase.

Adding first-line options in NSCLC – nivolumab+ipilimumab immunotherapy combination:

  • The combination improved OS in patients both positive for PD-L1 (17.1 vs 14.9 months, HR 0.79) and negative (17.2 vs 12.2 months, HR 0.62).
  • The number of first-line treatment options for NSCLC continues to grow.
  • Full coverage on Univadis.

Third-generation TKI as first-line treatment for EGFR-mutated NSCLC:

  • Even with active first generation TKI comparator, osimertinib improved median OS from 31.8 to 38.6 months (HR 0.799).
  • Benefit maintained across subgroups.

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