Surgical Advances and Targeted Drugs Reshape Ovarian Cancer Care: An Interview with Brian Slomovitz, MD
The field of ovarian cancer treatment is rapidly evolving, with new research and clinical trials offering hope for patients. In this interview, Brian Slomovitz, MD, discusses key trials and surgical advances that are transforming the care of patients with ovarian cancer.
Systemic Therapy Combinations for Platinum-Resistant Ovarian Cancer (PROC):
One of the most significant advancements in PROC treatment is the development of new systemic therapy combinations. Dr. Slomovitz highlights the phase 3 ROSELLA trial (NCT052574080), which showed that adding relacorilant plus nab-paclitaxel (Abraxane) to standard treatment significantly improved progression-free survival (PFS) in patients with PROC. The median PFS was 6.54 months with the combination therapy, compared to 5.52 months with nab-paclitaxel alone.
Emerging Targeted Options for Low-Grade Serous Disease:
For low-grade serous ovarian cancer, Dr. Slomovitz emphasizes the importance of emerging targeted therapies. He discusses the FDA approval of avutometinib plus defactinib (Avmapki Fakzynja Co-pack) for patients with previously treated, KRAS-mutated recurrent low-grade serous ovarian cancer. This combination therapy has redefined treatment options for this challenging subtype of the disease.
Surgical Advances and Minimally Invasive Procedures:
Surgical interventions are also evolving, with a focus on minimally invasive procedures. Dr. Slomovitz mentions the ongoing MIRRORS-FROZEN trial (NCT06638593), which aims to evaluate the role of re-evaluated robotics versus open surgery in ovarian cancer treatment. Additionally, the LANCE trial (NCT04575935) is investigating the benefits of minimally invasive interval debulking surgery in patients with advanced-stage ovarian cancer.
Future Shifts in PROC Treatment:
When asked about future shifts in PROC treatment, Dr. Slomovitz highlights the KEYNOTE-B96 trial (NCT05116189). The trial demonstrated that adding pembrolizumab to weekly paclitaxel significantly improved PFS in the intention-to-treat population. This is a groundbreaking finding, as it represents the first phase 3 study in ovarian cancer to show a statistically significant overall survival (OS) benefit for an immune checkpoint inhibitor regimen.
Long-Term Research and Maintenance Trials:
In the platinum-sensitive setting, Dr. Slomovitz discusses ongoing maintenance trials, such as the phase 3 RAINFOL-04 study (NCT07225270) evaluating the antibody-drug conjugate rinatabart sesutecan (Rina-S) in ovarian cancer. He also mentions the long-term follow-up data from the SOLO1 trial (NCT01844986), which continues to show the advantage of maintenance olaparib in achieving cures for some patients with newly diagnosed advanced ovarian cancer.
Emerging Therapies for Low-Grade Serous Ovarian Cancer:
Low-grade serous ovarian cancer is a complex subtype, and Dr. Slomovitz acknowledges the need for better treatment options. He suggests that hormonal therapy in the maintenance setting may be beneficial in preventing recurrences. The recent investigation of the MEK/FAK inhibitor combination of avutometinib plus defactinib received accelerated FDA approval, offering hope for patients with KRAS-mutated recurrent low-grade serous ovarian cancer.
Stay tuned for more updates on these exciting developments in ovarian cancer research and treatment.
