A recent report published in The Oncologist details the treatment patterns and outcomes for 3 patients with platinum-resistant ovarian cancer who received immunotherapy, which was followed by antiangiogenic therapy with chemotherapy. The report was authored by Rachel E. Kinney, DO, of Lehigh Valley Topper Cancer Institute in Allentown, Pennsylvania, and colleagues.
All 3 patients had recurrent, metastatic disease. However, the authors explained in their report that progression-free survival and overall survival were both prolonged for patients in this case series following inhibition of programmed cell death protein 1 (PD-1) and the use of cytotoxic plus antiangiogenic treatments afterward. Also, they noted, longer survival in these patients did not appear accompanied by decreased quality of life.
“These observations shed light on the interactions between chemotherapy and immunotherapy, a rapidly evolving area of research in the field of oncology,” Dr Kinney and colleagues wrote in their report.
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Patients in this case series were aged 69, 55, and 51 years, and all had diagnoses of stage IIIC ovarian cancer. Overall, each patient received several lines of systemic therapy, often including combination therapies. Following initial surgical and platinum-based chemotherapeutic approaches, all 3 patients eventually showed evidence of disease progression.
Each patient then received either nivolumab with ipilimumab or pembrolizumab with niraparib. All later received paclitaxel plus bevacizumab, with or without additional agents. Levels of the biomarker CA-125 varied across these patients after these steps but appeared to show stabilization or improvement for a period of time after receiving paclitaxel plus bevacizumab before later rising again.
One patient entered hospice care 50 months after her initial stage IIIC ovarian cancer diagnosis, and this was 36 months after onset of platinum resistance. One patient died 71 months after initial diagnosis, and this was 23 months after her condition had become platinum refractory. The third patient lived for 51 months following the initial diagnosis and 15 months after her disease became platinum resistant.
“Further studies evaluating the role of immunotherapy followed by chemotherapy in combination with drugs targeting angiogenesis are needed and may provide a long-sought after breakthrough for advancing survival in platinum-resistant ovarian cancer,” the authors concluded in their report.
Reference
Kinney RE, Nair S, Kim CH, Thomas MB, DelaTorre M. Immunotherapy may improve tumor sensitivity to palliative chemotherapy in platinum resistant ovarian cancer. Oncologist. Published online April 7, 2023. doi:10.1093/oncolo/oyad079
