Bevacizumab, olaparib, and durvalumab in patients with relapsed ovarian cancer: a phase II clinical trial from the GINECO group

• Published in: Nature communications 2024-03, Vol.15 (1), p.1985-1985, Article 1985
• Main Authors: Freyer, Gilles, Floquet, Anne, Tredan, Olivier, Carrot, Aurore, Langlois-Jacques, Carole, Lopez, Jonathan, Selle, Frédéric, Abdeddaim, Cyril, Leary, Alexandra, Dubot-Poitelon, Coraline, Fabbro, Michel, Gladieff, Laurence, Lamuraglia, Michele
• Format: Article
• Language: English
• Subjects: 49/39; 631/67/1517/1709; 692/4028/67/1059; 692/4028/67/1517/1709; Antibodies, Monoclonal; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Bevacizumab; Bevacizumab - therapeutic use; Cancer; Carcinoma, Ovarian Epithelial; Chemotherapy; Chronic Disease; Female; Humanities and Social Sciences; Humans; Medical prognosis; multidisciplinary; Ovarian cancer; Ovarian Neoplasms - drug therapy; PD-1 protein; Phthalazines; Piperazines; Platinum; Recurrence; Safety; Science; Science (multidisciplinary); Statistics; Survival
• ISSN: 2041-1723; 2041-1723
• DOI: 10.1038/s41467-024-45974-w

Most patients with advanced ovarian cancer (AOC) ultimately relapse after platinum-based chemotherapy. Combining bevacizumab, olaparib, and durvalumab likely drives synergistic activity. This open-label phase 2 study (NCT04015739) aimed to assess activity and safety of this triple combination in female patients with relapsed high-grade AOC following prior platinum-based therapy. Patients were treated with olaparib (300 mg orally, twice daily), the bevacizumab biosimilar FKB238 (15 mg/kg intravenously, once-every-3-weeks), and durvalumab (1.12 g intravenously, once-every-3-weeks) in nine French centers. The primary endpoint was the non-progression rate at 3 months for platinum-resistant relapse or 6 months for platinum-sensitive relapse per RECIST 1.1 and irRECIST. Secondary endpoints were CA-125 decline with CA-125 ELIMination rate constant K (KELIM-B) per CA-125 longitudinal kinetics over 100 days, progression free survival and overall survival, tumor response, and safety. Non-progression rates were 69.8% (90%CI 55.9%-80.0%) at 3 months for platinum-resistant relapse patients (N = 41), meeting the prespecified endpoint, and 43.8% (90%CI 29.0%-57.4%) at 6 months for platinum-sensitive relapse (N = 33), not meeting the prespecified endpoint. Median progression-free survival was 4.1 months (95%CI 3.5–5.9) and 4.9 months (95%CI 2.9–7.0) respectively. Favorable KELIM-B was associated with better survival. No toxic deaths or major safety signals were observed. Here we show that further investigation of this triple combination may be considered in AOC patients with platinum-resistant relapse. Prognosis for patients diagnosed with advanced stage ovarian cancer remains poor. Here the authors report the results of a phase 2 study of a triple combination of the PARP inhibitor olaparib in combination with durvalumab (anti-PD1) and bevacizumab (antiVEGF) in advanced ovarian cancer.