New drug combination effective in patients with advanced ovarian cancer

A new study by researchers at the Yale Cancer Center and the University of Maryland Comprehensive Cancer Center shows that ixabepilone plus bevacizumab (IXA+BEV) is an effective and well-tolerated combination for the treatment of ovarian cancer platinum/taxane resistant compared to ixabepilone (IXA) alone. Data show that it can also significantly prolong both progression-free survival and overall survival. The results were published in the British Journal of Cancer.

“New approaches for relapsed ovarian cancer are desperately needed as there are currently limited effective combinations to treat our patients. The results of this study demonstrated a drug combination that could be an effective treatment for this type of ovarian cancer,” said Alessandro Santin, MD, professor of obstetrics, gynecology and reproductive sciences at the Yale School of Medicine and Disease Aligned Research Team Leader for the Gynecologic Cancer Program at Yale Cancer Center and Smilow Cancer Hospital and lead author of the study.

Ovarian cancer is the deadliest gynecological malignancy. According to the American Cancer Society, nearly 20,000 women will be diagnosed with ovarian cancer in the United States each year and more than 12,000 women will die from it. IXA is a microtubule stabilizing agent that may be beneficial in patients treated with platinum/paclitaxel. Bevacizumab (BEV) is an antibody that prevents the formation of new blood vessels and has shown clinical activity in ovarian cancer.

In this phase II study, researchers randomly assigned 78 patients to receive IXA+BEV or IXA alone. The primary endpoint was progression-free survival (PFS), overall survival (OS), safety, and response rates served as secondary endpoints. The researchers also investigated whether the presence of the TUBB3 protein in the tumor could predict clinical response to these drugs. Among 76 evaluable patients who received IXA+BEV versus IXA, the response rate was 33% versus 8%, with sustained clinical benefit at 6 months in 37% and 3%. Adding BEV significantly improved both PFS (5.5 months versus 2.2 months) and OS (10 months versus 6 months). Both regimens were well tolerated.

“We expect our findings to have major implications for the field of gynecologic oncology, as they add a new, effective treatment for these extremely challenging tumors for which there are otherwise few options,” said the former. author Dana M. Roque, MD, associate professor in the Division of Gynecologic Oncology at the University of Maryland School of Medicine and member of the Marlene & Stewart Greenebaum Comprehensive Cancer Center.

Other Yale study authors include: Gloria Huang, MD, Gulden Menderes, MD, and Elena Ratner, MD, Natalia Buza, MD, Stefania Bellone, PhD, Vaagn Andikyan, MD, Mitchell Clark, MD, Masoud Azodi, MD, Peter E. Schwartz, MD, Pei Hui, MD, PhD, Joan R. Tymon-Rosario, Justin Harold, MD, Dennis Mauricio, Burak Zeybek, and Gary Altwerger, MD.

Reference: Roque DM, Siegel ER, Buza N, et al. Phase II randomized trial of weekly ixabepilone ± biweekly bevacizumab for platinum-resistant or refractory ovarian/fallopian tube/primitive peritoneum cancer. Br J Cancer. 2022:1-9. doi: 10.1038/s41416-022-01717-6

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