ASCO23 Day 3 :Parp Inhibitors & Late Breaking Abstract session

While there were fewer gynecologic cancer sessions on Day 3, Sunday June 4th there were two important sessions regarding the use of PARP inhibitors and trial results for a drug to teat  platinum resistant ovarian cancer drug which may be change practice.

Parp Inhibitor Optimal Selection and Toxicity Management 

Dr Tew - Status updates on Parp use

Dr Friedlander- Real World Experience in Managing PARP Toxicities 

 

 

 Susan Feinberg  (FORCE) - Living on a PARPi 

 

Late Breaking Abstract Session  

Mirvetixumab in Folate Receptor Alpha positive platinum resistant ovarian cancer

I wish I had been able to be in the room when this session took place. I could feel the excitement from the Tweets being posted.  This is the first trial to show overall survival benefit in platinum resistant ovarian cancer! This is practice changing. 

Wow! Amazing to see an #OverallSurvival benefit for Mirvetuximab for patients with platinum resistant #OvarianCancer
🚨 new standard of care alert 🚨 #GynCSM #ASCO23
Congrats to the investigators and patients who made this #research possible! @ASCO pic.twitter.com/ojYBIDKYS0

— Megan Hutchcraft MD (@MeganLeigh127) June 4, 2023

🚨Amazing to see ⬆️ in overall survival for mirvetixumab in FOLR1 positive platinum resistant #ovariancancer. Absolutely new standard of care!! 👏 #gyncsm #ASCO23 pic.twitter.com/yweWSh5qES

— Eleonora Teplinsky, MD (@drteplinsky) June 4, 2023

I shared tweets others wrote about the MIRASOL trial (mirvetixumab in FOLR1 positive platinum resistant #ovariancancer ) but... this slide says it all . #ASCO23 #gyncsm pic.twitter.com/Sif0gn76a8

— Dee Sparacio (@womenofteal) June 4, 2023

 Here is a slide of the overall survival  MIRV 16.46 months vs investigator choice of treatment 12.75 months.

 Stop by tomorrow for highlights from my last day of ASCO - Day 4 . 

Dee

Every Day is a Blessing

SGO Annual Mtg 2023 Highlights : Ovarian Cancer

I've gathered together some interesting Tweets about ovarian cancer research studies from the SGO 2023 Annual Meeting.

Botensilimab An Fc-engineered recombinant human immunoglobulin (Ig) G1 monoclonal antibody and Balstilimab a PD-1 inhibitor 

Botensilimab, BOT, a novel innate/adaptive
immune activator, plus balstilimab
(anti-PD-1) in patients with recurrent
platinum refractory/resistant ovarian cancer, #SGOmtg #gyncsm Bockorny
BOT = CTLA 4 inhibitor, 1st in Human study ,heavily pretreated ORR 33%, pic.twitter.com/7sz5YtLTGa

— Dee Sparacio (@womenofteal) March 27, 2023

Additional information  https://www.cancernetwork.com/view/botensilimab-plus-balstilimab-yields-enduring-responses-in-r-r-ovarian-cancer

 

SOLAR Trial olaparib (Lynparza) with selumetinib (Koselugo) in patients with RAS-mutant gynecologic malignancies

Exciting data from the SOLAR trial presented by ⁦@ShannonWestin⁩ on the use of combination PARPi and MEKi for RAS mutated recurrent ovarian and endometrial cancer! #SGOmtg #oncsurgery ⁦@MDAndersonNews⁩ pic.twitter.com/sxPEFOcDMI

— Aaron Shafer (@aaronshafer99) March 27, 2023

Find additional information at https://www.onclive.com/view/dr-westin-on-outcomes-of-the-solar-trial-in-ras-mutant-gynecological-malignances

SOLO 1 trial results - 7 year overall survival reported

The 7-year results of SOLO1 study have reported!

Amazingly they got a great durable benefits in OS as well as TFST/TSST, which means most of patients who recieved olaparib as maintenance therapy haven't experienced relapse.#SGOMtg pic.twitter.com/lYr6RHz8yl

— Yukio Suzuki (@yetii18) March 26, 2023

Solo-1 7year follow up presented by Cara Matthews @SGO_org annual meeting. Survival benefits confirmed. No new safety signals. #SGOmtg #gyncsm pic.twitter.com/JP0qkEKkwc

— Annie Ellis (@Stigetta) March 26, 2023

Additional information may be found at https://www.onclive.com/view/dr-mathews-on-maintenance-olaparib-in-ovarian-cancer

 

NOVA trial Recurrent ovarian cancer - Niraparib (Zejula) did not produce a statistically significant overall survival (OS) benefit compared with placebo.  

Dr. Ursula Matulonis presents Final OS and Safety for ENGOT-OV16/NOVA. No new safety signals. #SGOmtg #gyncsm pic.twitter.com/kG7gG39gWo

— Annie Ellis (@Stigetta) March 26, 2023

 

Minimally invasive surgery vs open surgery

Impressive results from @KJorgensenMD. Study of NCDB demonstrated improved overall survival w/ minimally invasive surgery as opposed to open interval tumor reductive surgery in advanced #OvarianCancer. The LANCE study will provide prospective data here #SGOMtg #oncsurgery #gyncsm pic.twitter.com/STE3UNz7zc

— Shannon Westin (@ShannonWestin) March 26, 2023

 

Neoadjuvant olaparib - improved surgical outcomes 

After neoadjuvant talazoparib results in BRCAm BC (Litton J.K. 2017), neoadjuvant olaparib in #ovariancancer (with mutation in BRCA1/2, RAD51C/D, or PALB2) by @ShannonWestin shows outstanding surgical outcomes after only 2 cycles of olaparib, even in Stage IV pts #SGOMTG #SGO2023 pic.twitter.com/T4Rdk9pCJ5

— Allegra Rollo (@AllegraRollo) March 25, 2023

 For additional information see https://www.onclive.com/view/neoadjuvant-olaparib-proves-feasible-aids-optimal-resection-in-brca-mutant-ovarian-cancer

mirvetuximab soravtansine-gynx (Elahere)

Learning more about Elahere a monoclonal antibody directed against folate receptor alpha in OC @ImmunoGenInc Industry Sponsored session ~ 35% patients w/ OC express high levels SORAYA trial #SGOMtg #gyncsm pic.twitter.com/y6ThbanbWs

— Dee Sparacio (@womenofteal) March 25, 2023

Steroid eye drops followed by lubricating eye drops and regular visits to an ophthalmologist should be scheduled . For more information see https://www.onclive.com/view/dr-matulonis-on-the-management-of-mirvetuximab-soravtansine-related-toxicities-in-fr-ovarian-cancer

venous thromboembolism (VTE)

Higher Incidence of Venous Thromboembolism Associated with Increasing Lines of Chemotherapy in Heavily Treated Ovarian Cancer Patients
Lampert #SGOMtg #gyncsm single institution, VTE assoc w/ increasked # lines of treatment , > 50% of VTEs required hospitalization pic.twitter.com/DZFgpjzRgI

— Dee Sparacio (@womenofteal) March 28, 2023

 

For additional information see https://www.medpagetoday.com/meetingcoverage/sgo/103793

If you would like to share additional ovarian cancer studies presented at SGO 2023 please mention in the comment section below. Thanks.

Stop by tomorrow to read Tweets that highlighted studies on equity, diversity at the meeting.

 

Dee

Every Day is a Blessing! 

 

New FDA Approved Drug for Ovarian Cancer Recurrence - Impact on Patients

On November 14, 2022 the FDA granted accelerated approval of mirvetuximab soravtansine-gynx (Elahere, ImmunoGen, Inc.) and antibody drug conjugate. (https://www.fda.gov/drugs/resources-information-approved-drugs/fda-grants-accelerated-approval-mirvetuximab-soravtansine-gynx-fra-positive-platinum-resistant) . Women who have received one to three prior treatments and have folate receptor alpha (FRα) positive, platinum-resistant epithelial ovarian, fallopian tube, or primary peritoneal cancer can receive the drug. The FDA also approved the companion assay device (VENTANA FOLR1 (FOLR-2.1) RxDx Assay ) for determining folate receptor alpha (FRα). The device is made by Ventana Medical Systems, Inc.

The approval was based on the results of the SORAYA Study NCT04296890), a single-arm trial of 106 women who had up to three other treatments and also received bevacizumab. Patients who had ocular, corneal, grade 1 neuropathy or lung infection issues were excluded. The Overall Response Rate (ORR) was 31.7% and median Duration of  Response (DOR) was 6.9 months. 

Women who are given the drug will receive a dose of 6 mg/kg adjusted ideal body weight every 3 weeks by IV. I wondered what adjusted ideal body weight was, so  I found this formula for calculating it. Adjusted body weight(ABW) = Ideal Body Weight(IBW)  + 0.25 * (ABW - IBW)                         Source: (https://pubmed.ncbi.nlm.nih.gov/22836946/)

Some side effects women in the study experienced included vision impairment, fatigue, nausea, abdominal pain, peripheral neuropathy, diarrhea, decreased albumin, constipation, dry eye, decreased magnesium, etc. There is a warning for ocular toxicity. You may learn more at https://ascopost.com/issues/december-10-2022/fda-grants-accelerated-approval-to-mirvetuximab-soravtansine-gynx-for-fr-positive-platinum-resistant-epithelial-ovarian-fallopian-tube-or-peritoneal-cancer/ .

 I often wondered how fast drug approval translates into actual use in the clinic. It has been one month since the approval took place. The following is anecdotal information but I thought it was interesting enough to share. In that one month's time,  I have offered peer support to three women dealing with recurrent ovarian cancer. Two of those women brought up to me that their oncologists told them about the new drug "with the very long name". It seems like no one called it , Elahere. One has been already tested to see if she was folate receptor alpha (FRα) positive. One was told about it but will continue with her current treatment which is going well for her. But she was happy to have another option  for the future. One did not mention the new drug during our conversation. 

In the ASCO Post Article noted above Ursula A. Matulonis, MD, Chief of the Division of Gynecologic Oncology and the Brock-Wilson Family Chair at Dana-Farber Cancer Institute and co-leader of the SORAYA study stated “There have been no approved therapies for platinum resistant ovarian cancer since 2014, so [this] action by the FDA is a very significant milestone.”  I agree and I am happy to see how quickly oncologists are sharing the information about the drug with the patients. 

 

Dee

Every Day is a Blessing!