Women with ovarian cancer report a better quality of life when treated with a combination of Keytruda, Avastin and oral metronomic cyclophosphamide.
New drug treatment consisting of a combination of Keytruda (pembrolizumab), Avastin (bevacizumab) and oral metronomic cyclophosphamide shows efficacy, safety and better quality of life in patients with recurrent platinum-sensitive, platinum resistant, or refectory epithelial ovarian, fallopian tube or primary peritoneal cancer, according to a phase two nonrandomized study in JAMA Oncology.
Of the possible treatment options for ovarian cancer, they are often limited in clinical benefit and negatively affect the patient’s quality of life, leading to an unmet need for a tolerable therapy.
This study consisted of 40 women who had recurrent ovarian cancer, measurable disease per immune-related Response Evaluation Criteria in Solid Tumors (irRECIST), and Eastern Cooperative Oncology Group (ECOG) performance status of zero to one. Enrollment of patients started from Sept. 6, 2016 to June 27, 2018.
The patients received 200mg of Keytruda and 15mg/kg of Avastin every three weeks, in addition to a daily dosage of 50mg of oral cyclophosphamide. They received this treatment until there was disease progression, toxic effects or study withdrawal.
Of the 40 enrolled, patients 39 discontinued treatment due to progressive disease and requested treatment break and withdrawal, but all 40 were evaluated for safety and efficacy data.
This study’s primary reason for research was to find the objective response rate (ORR) and progression-free survival (PFS) using irRECIST. Other outcomes included frequency and severity of events, duration of response (DOR), overall survival, treatment response and quality of life.
Three women had completed responses, 16 had partial response, and 19 had stable disease in response to treatment. The ORR was 47.5%, clinical benefit was seen in 38 women and durable response was seen in 10. The seven-month PFS rate was 0.67, authors note that this rate “exceeded the predefined threshold of 0.3 for a heavily pretreated ovarian cancer cohort.”
The patients were given quality of life questionaries at the baseline of the study and then again at three and six months into treatment. During the trial global and physical functioning scores remained high, body image, emotional functioning and social functioning all have improved scores.
This combination of Keytruda with Avastin and oral cyclophosphamide gave positive results, as it was well tolerated by patients. This study gives a possible future option in clinical practice that has not been met yet.