Adding Lynparza to Avastin Significantly Improves Survival in Ovarian Cancer

Courtney Marabella

Maintenance treatment with Lynparza plus Avastin over Avastin alone provided a certain group of patients with ovarian cancer a substantial survival benefit.

Patients with homologous recombination deficiency (HRD)–positive, newly diagnosed advanced ovarian cancer, regardless of disease stage, achieved a substantial survival benefit after treatment with Lynparza (olaparib) plus Avastin (bevacizumab) compared to Avastin alone in the first-line maintenance setting, according to recent study results.

The findings, which were presented during the American Society of Clinical Oncology (ASCO) Annual Meeting, demonstrated that at a median follow-up of 24.8 months, the addition of Lynparza to Avastin was associated with a median progression-free survival (time during and after treatment when the patient lives without disease progression) of 39.3 months in patients with HRD-positive tumors and stage 3 disease. The median progression-free survival was 19.9 months among patients with the same tumor and stage of disease who received Avastin alone.

In patients with HRD-positive tumors and stage 4 disease, the median progression-free survival with the combination was 25.1 months compared to 12.8 months in the single-agent Avastin group.

Moreover, in patients with lower risk disease, defined as those with stage 3 disease who did not have residual disease following up-front surgery, the median progression-free survival 2 (time from randomization to tumor progression on next-line treatment or death from any cause) was not reached with the doublet compared to 44.3 months with Avastin alone.

In those with higher risk disease, defined as those with stage 3 disease who have residual disease following up-front surgery or who received neoadjuvant chemotherapy or those who have stage 4 disease, the median progression-free survival with the combination was 50.3 months compared to 32.6 months with Avastin alone.

“Remarkably, the two- and three-year (progression-free survival) 2 rates were greater than 90% with maintenance (Lynparza) plus (Avastin) in lower risk patients with HRD-positive tumors who benefitted from complete resection during up-front surgery,” lead study author Dr. Patricia Pautier, head of the Medical Day Hospital Unit at the Institut Gustave Roussy Cancer Campus in France, said during a presentation of the data.

In the analysis presented during the ASCO Annual Meeting, investigators sought to explore the efficacy of the regimen in patients with HRD-positive tumors by disease stage and surgical outcome.

Patients enrolled to the study had newly diagnosed, stage 3 to stage 4 high-grade serous or endometroid ovarian, fallopian tube, and/or peritoneal cancer. Patients received first-line treatment with up-front or interval surgery, platinum/taxane-based chemotherapy, and two or more cycles of Avastin.

Study participants were randomized to receive either Lynparza for two years plus Avastin, or placebo plus Avastin.

Of the 806 patients who were randomized on study, 48% had HRD-positive status; 70% had stage 3 disease and 30% had stage 4 disease.

Additional data showed that in those with HRD positivity and stage 3 disease, the two-year progression-free survival rate with the combination was 72% compared to 36% with Avastin alone. In those with HRD positivity and stage 4 disease, the two-year progression-free survival rates in the combination and single-agent treatment groups were 52% and 17%, respectively.

When analyzing patients with lower-risk disease, the progression-free survival 2 rates at two years in the combination and single-agent groups were 94.7% vs 90.6%, respectively; at three years, these rates were 91.9% vs 65.7%, respectively. In patients with higher risk disease, the two-year progression-free survival 2 rates in the Lynparza plus Avastin and Avastin alone groups were 73.9% and 69.1%, respectively; the three-year progression-free survival rates were 57.1% and 42.3%, respectively.

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