Advertisement


Benoit You, MD, PhD, on Ovarian Cancer: Who Benefits From Bevacizumab in the First-Line Setting

2022 ASCO Annual Meeting

Advertisement

Benoit You, MD, PhD, of Lyon University hospital (HCL, France) and GINECO group (France), discusses findings from the GOG-0218 trial of patients with ovarian cancer, which appears to confirm earlier data on the link between poor tumor chemosensitivity and benefit from concurrent plus maintenance bevacizumab. In Dr. You’s validation study, patients who derived the most progression-free and overall survival benefit from bevacizumab were those with high-risk disease (stage IV or incompletely resected stage III) associated with an unfavorable KELIM score (CA-125 kinetic elimination rate constant, calculable online) (Abstract 5553).



Transcript

Disclaimer: This video transcript has not been proofread or edited and may contain errors.
I presented the results of a validation study done in collaboration with the U.S. GOG group about the patients with ovarian carcinoma who have the maximum benefit from bevacizumab. Bevacizumab has been approved for patients with ovarian carcinoma stage 3 and stage 4. However, there is still a big debate about what patients should actually be treated with bevacizumab, because two main large phase III trials had inconsistent outcomes about the characteristics of patients who had a maximum overall survival benefit, and there was no real biomarker of bevacizumab efficacy. So we assume that the tumor primary chemosensitivity, meaning the sensitivity of the tumor to the first cycle of chemotherapy assessed by the model CA-125 kinetic parameter KELIM, could be an interesting parameter. In an initial study with ICON7 trial, we found that among patients with high-risk disease, meaning stage 3 incompletely resected and stage 4 disease, only those who had unfavorable KELIM score, meaning poly-chemosensitive disease, had the benefit from bevacizumab. So, a validation was needed, and this is what we did with the U.S. GOG group on the trial, the GOG-0218 trial. KELIM was assessed by our team, and then we sent the KELIM score to the statistic team of the GOG group. We had very consistent outcomes. In patients with high-risk disease, only those who had unfavorable KELIM score, meaning poly-chemosensitive disease, had the benefit in overall survival by about 6 months, 29 to 35 months. And in patients with low-risk disease, those who had favorable KELIM, meaning highly chemosensitive disease, they had deleterious effect of bevacizumab on the overall survival by about 17 months. So, in conclusion, the two studies are now very consistent in terms of outcomes. We reconcile the data of the two trials. The survivor cures are very, very similar, and we consider that the tumor primary chemosensitivity is probably a biomarker of bevacizumab efficacy. So bevacizumab should be encouraged in patients with high-risk disease and poly-chemosensitive disease, but should be discouraged in patients with low-risk disease and highly chemosensitive disease. Just of note, KELIM can be calculated online for your patient. You will be requested to enter the dates of the first three cycles of chemotherapy, the value of CA-125, and the dates of CA-125. You press compute and you will have the KELIM score for your patients.

Related Videos

Skin Cancer
Immunotherapy

Georgina V. Long, MD, PhD, on Melanoma: Distant Metastasis–Free Survival With Adjuvant Pembrolizumab

Georgina V. Long, MD, PhD, of the Melanoma Institute Australia, The University of Sydney, discusses phase III findings from the KEYNOTE-716 study. The trial showed that compared with placebo, adjuvant pembrolizumab significantly improved distant metastasis–free survival in patients with resected stage IIB and IIC melanoma. The findings also suggest a continued reduction in the risk of recurrence and a favorable benefit-risk profile (Abstract LBA9500).

Gynecologic Cancers

Bradley J. Monk, MD, on Ovarian Cancer: New Data on Rucaparib Monotherapy vs Placebo as Maintenance Treatment

Bradley J. Monk, MD, of the University of Arizona College of Medicine and Creighton University School of Medicine, discusses phase III findings from the ATHENA–MONO (GOG-3020/ENGOT-ov45) trial. It showed that rucaparib as first-line maintenance treatment, following first-line platinum-based chemotherapy, improved progression-free survival in patients with ovarian cancer, irrespective of homologous recombination deficiency status (Abstract LBA5500).

Breast Cancer
Immunotherapy

Ann H. Partridge, MD, MPH, and Ian E. Krop, MD, PhD, on Metastatic Breast Cancer: New Early Data on Patritumab Deruxtecan

Ann H. Partridge, MD, MPH, Dana-Farber Cancer Institute, and Ian E. Krop, MD, PhD, of Yale Cancer Center, discuss phase I/II findings on patritumab deruxtecan, a HER3-directed antibody-drug conjugate, in patients with HER3-expressing metastatic breast cancer. A pooled analysis showed antitumor activity in women with HR-positive/HER2-negative and HER2-positive advanced disease, as well as triple-negative breast cancer (Abstract 1002).

Prostate Cancer

Alicia K. Morgans, MD, MPH, and Ian D. Davis, PhD, MBBS, on Prostate Cancer: Updated Overall Survival Outcomes With Enzalutamide

Alicia K. Morgans, MD, MPH, of Dana-Farber Cancer Institute, and Ian D. Davis, PhD, MBBS, of Monash University and Eastern Health, discuss the latest findings from ANZUP Cancer Trials Group’s ENZAMET cooperative group trial of enzalutamide in patients with metastatic hormone-sensitive prostate cancer. The results corroborate the benefit of enzalutamide with improved overall survival, and involve some exploratory subgroup analyses (Abstract LBA5004).

Colorectal Cancer

Michael J. Overman, MD, and Jeanne Tie, MBChB, MD, on Colon Cancer: Guiding Adjuvant Chemotherapy With ctDNA

Michael J. Overman, MD, of The University of Texas MD Anderson Cancer Center, and Jeanne Tie, MBChB, MD, of Peter MacCallum Cancer Centre, discuss results from the DYNAMIC trial, in which a circulating tumor DNA (ctDNA)-guided approach reduced the use of adjuvant chemotherapy without compromising recurrence-free survival in patients with stage II colon cancer (Abstract LBA100).

Advertisement

Advertisement




Advertisement