As part of the NOGGO update on gynecologic oncology, the most important studies presented at this year’s ASCO conference were discussed. For patients with advanced ovarian cancer, the focus was primarily on the optimal treatment strategy as well as new targeted and cell-based therapies.
Ovarian cancer
Primary Treatment: Surgery Remains the Most Important Component
The results of the TRUST study confirm the current standard of care. The study investigated whether patients who are initially ineligible for surgery would benefit from six cycles of chemotherapy instead of three prior to surgery.
However, the study did not show any benefit from longer chemotherapy prior to surgery. It did not improve the likelihood of complete tumor removal, progression-free survival, or overall survival.
The experts therefore conclude that if surgery does not appear feasible after three cycles of chemotherapy, the focus should be on drug therapy. Re-evaluating the need for surgery after six cycles did not provide any additional benefit.
The current guidelines therefore remain unchanged: If complete removal of the tumor is possible with an acceptable level of risk, the goal should continue to be primary surgery followed by systemic therapy.
Platinum-Resistant Ovarian Cancer: Hope Through New Targeted Therapies
The NAPISTAR-1-01 study, which investigated the new antibody-drug conjugate TUB-040, showed promising results. Antibody-drug conjugates (ADCs) specifically target cancer cells and deliver a cytotoxic agent directly into the tumor cells.
Although this is still an early Phase 1 trial, progression-free survival was approximately 11 months— an encouraging result for patients with platinum-resistant ovarian cancer, for whom existing treatment options often only allow for significantly shorter periods of disease control. Another particularly positive finding was that no ocular toxicity was observed, a side effect that can occur more frequently with other ADC therapies.
New Immunotherapy: T-Cell Therapy Shows Initial Success
Another Phase 1 study evaluated the T-cell therapy IMA203CD8 in patients with advanced ovarian cancer who had already received several treatments.
In this form of treatment, the body’s own immune cells are specifically trained to recognize and attack a particular protein on the tumor cells (PRAME).
The initial results are promising: The tumor shrank in 78% of the patients, and an objective response to treatment was observed in 63%. In addition, many of the treatment successes achieved persisted over a longer period of time; the longest complete metabolic remission observed to date was still present even twelve months after treatment. Overall, the treatment was well tolerated.
Since this is also an early-stage clinical trial, further research is needed before this treatment can be used in routine clinical practice.
Endometrial Cancer
RUBY Study: Long-Term Benefits of Immunotherapy Confirmed
New long-term data from the RUBY study confirm the sustained benefit of the immunotherapy dostarlimab in combination with chemotherapy in patients with dMMR endometrial cancer (tumors with a DNA repair defect).
Long-term follow-up shows that many female patients benefit from the treatment over the long term and live without disease progression. According to the study authors, some of these patients may even have the prospect of long-term disease control or even a possible cure.
The results thus underscore the importance of the combination of dostarlimab and chemotherapy in patients with dMMR endometrial cancer.
Abstracts of the studies presented can be found directly on the ASCO website (the site is in English).
Over the next few days, you’ll also find short videos highlighting the highlights of ASCO on our social media channels!
