Reported by Dr Laure-Anne Teuwen – University Hospital Antwerp
Laure-Anne Teuwen, a medical oncologist at the University Hospital of Antwerp, presents a selection of key studies in the field of gynaecological cancer discussed at ESMO 2023.
Endometrial Cancer Studies:
A phase II dose expansion study of Luvelta, an antibody-drug conjugate targeting Folate Receptor Alpha (FolRα), showed promise in recurrent or metastatic epithelial endometrial cancer patients who had progressed on previous therapy. The study demonstrated objective response rates, especially in patients with high FolRα expression levels. Haematological side effects were observed, and further data from a modified protocol is anticipated.
The RUBY trial, an exploration into primary advanced endometrial cancer treatment, focused on the addition of dostarlimab, a PD-1 inhibitor, to carboplatin-paclitaxel chemotherapy. Initially, dostarlimab was administered concurrently with chemotherapy for six cycles and continued as monotherapy for up to three years. Primary endpoints included progression-free survival and overall survival. During ESMO, data was presented regarding PFS and OS, categorised by molecular subgroups. Intriguingly, the mismatch repair deficient and TP53 abnormal subgroups exhibited similar improvements in both endpoints. The subgroup with no specific molecular profile showed enhanced progression-free survival, though events were insufficient for overall survival analysis. Across all physiological subgroups, including carcinosarcoma, beneficial effects were observed.
Cervical Cancer Study:
A phase two study evaluated QL1706, a bifunctional monoclonal antibody product of anti-PD-1 and anti-CTLA-4, in first-line therapy for metastatic or recurrent cervical cancer. QL1706 combined with chemotherapy exhibited promising overall response rates, and the trial showed that adding CTLA-4 inhibition to PD-1 inhibition was feasible and safe. A phase III study is ongoing to explore this approach further.
Ovarian Cancer Study:
The BOUQUET trial is a phase II platform study focusing on patients with rare epithelial ovarian cancer subtypes. Cobimetinib was assessed in patients with BRAF, KRAS, NRAS, or NF alterations in recurrent or progressive non-high-grade serous ovarian cancer. Although the overall objective response rate was not impressive, certain subtypes, such as mesonephric-like adenocarcinoma and low-grade serous ovarian carcinoma, showed better responses. Further data and extension cohorts are needed to confirm these results.
Conclusion:
ESMO 2023 showcased significant advancements in gynaecological cancer research, offering hope for patients with recurrent or metastatic endometrial cancer, advanced cervical cancer, and rare ovarian cancer subtypes.
References
Bhavana Pothuri – Luveltamab tazevibulin (STRO-002), an anti-folate receptor alpha (FolRα) antibody drug conjugate (ADC), demonstrates clinical activity in recurrent/progressive epithelial endometrial cancer (EEC): STRO-002-GM1 phase I dose expansion – ESMO 2023 – #741MO
Mansoor Raza Mirza – Dostarlimab + chemotherapy for the treatment of primary advanced or recurrent endometrial cancer (pA/rEC): Analysis of progression free survival (PFS) and overall survival (OS) outcomes by molecular classification in the ENGOT-EN6-NSGO/GOG-3031/RUBY trial – ESMO 2023 – #740MO
Danbo Wang – Efficacy and safety of QL1706 plus paclitaxel and cisplatin/carboplatin +/- bevacizumab (Bev) as 1L treatment in recurrent or metastatic cervical cancer (r/mCC): a single-arm, multicenter phase II study – ESMO 2023 – #743MO
Isabelle L. Ray-Coquard – First results from the ENGOT-GYN2/GOG-3051/BOUQUET phase 2 biomarker-directed platform study: cobimetinib (cobi) or atezolizumab (atezo) + bevacizumab (bev) for persistent/recurrent rare epithelial ovarian cancer (eOC) – ESMO 2023 – #747MO
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