National Action Towards a World Free of Cervical Cancer for All Women

Abstract

Overall, the response rates were low, and there was no benefit associated with either of the experimental treatment arms including the CPI avelumab when compared with the control liposomal doxorubicin arm. It was notable that there was a high percentage of refractory patients (25%) in the study population; this is a particularly difficult group to treat. The investigators concluded that there was no significant improvement in PFS or OS. A subgroup analysis suggested that possibly patients who expressed PDL-1 expression may show benefit from the combination therapy, and expression was associated with a higher response rate. Dr Pujade-Lauraine concluded that, "…this is a negative trial. However, …it is the first step in the long story for the future of immunotherapy in ovarian cancer."Treatment of ovarian cancer is already quite difficult. Finding the correct postoperative treatment remains a challenge, and the patients enrolled in JAVELIN 200 are a particularly difficult group to treat. It is notable that the companion trial JAVE-LIN 100, which studied avelumab as maintenance therapy, also did not result in clinical benefit in the CPI arm. However, these trials are important. Given the success of CPIs in other cancers as well as cervix and endometrial cancer, there was hope that the CPIs would also result in remarkable benefit for ovarian cancer patients. The new wish for new agents such as CPI and PARP inhibitors is to find a combination treatment that will result in improved results. Luckily, many clinical trials evaluating CPI combinations are underway.-LVL)