Relapsed ovarian cancer: cediranib/olaparib combo extends PFS

  • Liu JF & al.
  • Ann Oncol
  • 7 Feb 2019

  • curated by Deepa Koli
  • Univadis Clinical Summaries
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Takeaway

  • Cediranib+olaparib significantly extends PFS in patients with relapsed platinum-sensitive ovarian cancer vs olaparib alone.
  • PFS and OS benefit was observed in patients with wild-type germline BRCA (gBRCA), but not in BRCA mutated patients.

Why this matters

  • Results call for further evaluation in wild-type gBRCA patients.

Study design

  • Randomized, open-label, phase 2 study.
  • 90 patients with relapsed platinum-sensitive ovarian cancer of high-grade serous/endometrioid histology or deleterious gBRCA1/2 mutation (gBRCAm) were randomly assigned to receive olaparib or cediranib+olaparib until disease progression.
  • Funding: National Cancer Institute; National Institutes of Health.

Key results

  • Median follow-up, 46 months.
  • Median PFS was significantly longer with cediranib+olaparib vs olaparib alone (16.5 vs 8.2 months; HR, 0.50; P=.006).
  • OS was not statistically different in the overall population (44.2 vs 33.3 months; HR, 0.64; P=.11).
  • In gBRCA wild-type/unknown patients, cediranib+olaparib significantly improved PFS (23.7 vs 5.7 months; P=.0013) and OS (37.8 vs 23.0 months; P=.047).
  • In gBRCA mutated patients, PFS and OS were similar between 2 groups.
  • Treatment-related toxicities were more common with cediranib+olaparib vs olaparib alone (478 vs 180 events).
  • Most common grade 3/4 adverse events with cediranib/olaparib were fatigue, diarrhea, and hypertension.

Limitations

  • Open label design; small size.

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