Uyar Denise, Michener Chad M, Bishop Erin, Hopp Elizabeth, Simpson Pippa, Zhang Liyun, Rader Janet S, Rose Peter G, Mahdi Haider S, Debernardo Robert, Christian Qiana, Bradley William
Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee, WI, United States.
Obstetrics and Gynecology Institute, Cleveland Clinic, Cleveland, OH, United States.
Front Oncol. 2024 Feb 12;14:1291090. doi: 10.3389/fonc.2024.1291090. eCollection 2024.
Incompletely resected epithelial ovarian cancer represents a poor prognostic subset of patients. Novel treatment strategies are needed to improve outcomes for this population. We evaluated a treatment strategy combining platinum-based chemotherapy with pembrolizumab followed by pembrolizumab maintenance therapy in the first-line treatment after incomplete resection of epithelial ovarian cancer patients.
This was a single-arm, non-randomized pilot study of carboplatin, taxane, and immune checkpoint inhibitor, pembrolizumab, followed by 12 months of maintenance pembrolizumab in patients with incompletely resected epithelial ovarian cancer (EOC).
A total of 29 patients were enrolled and evaluated for efficacy and safety. The best response to therapy was complete response in 16 (55%) patients, partial response in 9 (31%) patients, and 3 (10%) patients with progression of disease. The median progression-free survival (PFS) was 13.2 months. Grade 3 and 4 toxicities occurred in 20% of patients. In all, 7 patients discontinued therapy due to adverse events. Quality-of-life scores remained high during therapy. Response to therapy did not correlate with PD-L1 tumor expression.
Combination platinum-taxane therapy with pembrolizumab did not increase median progression-free survival in this cohort of patients.
EOC is an immunogenic disease, but immune checkpoint inhibitor therapy has yet to impact outcomes. The current study utilized pembrolizumab in combination with standard chemotherapy followed by a maintenance treatment strategy in incompletely resected EOC. Progression-free survival was not extended in this poor prognostic group with combined chemotherapy and immunotherapy.
https://clinicaltrials.gov/, identifier NCT 027766582.
上皮性卵巢癌切除不完全代表了预后较差的患者亚组。需要新的治疗策略来改善该人群的治疗效果。我们评估了一种治疗策略，即在上皮性卵巢癌患者切除不完全后的一线治疗中，将铂类化疗与帕博利珠单抗联合应用，随后进行帕博利珠单抗维持治疗。
这是一项单臂、非随机的试点研究，研究对象为接受卡铂、紫杉烷和免疫检查点抑制剂帕博利珠单抗治疗，随后对切除不完全的上皮性卵巢癌（EOC）患者进行12个月帕博利珠单抗维持治疗。
共有29例患者入组并评估疗效和安全性。治疗的最佳反应为16例（55%）患者完全缓解，9例（31%）患者部分缓解，3例（10%）患者疾病进展。中位无进展生存期（PFS）为13.2个月。20%的患者发生3级和4级毒性反应。共有7例患者因不良事件停药。治疗期间生活质量评分保持较高水平。治疗反应与PD-L1肿瘤表达无关。
在该队列患者中，铂类-紫杉烷联合帕博利珠单抗治疗并未增加中位无进展生存期。
EOC是一种免疫原性疾病，但免疫检查点抑制剂治疗尚未影响治疗效果。本研究在切除不完全的EOC中使用帕博利珠单抗联合标准化疗，随后采用维持治疗策略。在这个预后较差的组中，联合化疗和免疫治疗并未延长无进展生存期。
https://clinicaltrials.gov/，标识符NCT 027766582 。
