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Review Article| Volume 153, ISSUE 2, P436-444, May 2019

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Phase III trials in ovarian cancer: The evolving landscape of front line therapy

Published:February 12, 2019DOI:https://doi.org/10.1016/j.ygyno.2019.02.008
Phase III trials in ovarian cancer: The evolving landscape of front line therapy
Previous ArticleTherapeutic potential of the new TRIB3-mediated cell autophagy anticancer drug ABTL0812 in endometrial cancer
Next ArticleThe prognostic value of residual disease after neoadjuvant chemotherapy in advanced ovarian cancer; A systematic review

      Highlights

      • •
        There are many trials underway with biologic agents in combination and after primary chemotherapy for ovarian cancer.
      • •
        SOLO 1 has changed the standard primary therapy for women with BRCA mutated ovarian cancer.
      • •
        Other trials are likely to change the standard of care for the primary treatment of ovarian cancer.

      Abstract

      Introduction

      Ovarian cancer has a high mortality to case ratio. To improve the initial response to therapy, trials of biologic agents in combination with primary chemotherapy and as maintenance after completing chemotherapy are being conducted. Multiple trials are ongoing and this strategy has great promise. However, the changing landscape of primary treatment will make designing future trials in ovarian cancer difficult as there may not be a consensus on the optimal primary therapy.

      Materials and methods

      We reviewed clinicaltrials.gov for recent and ongoing phase III clinical trials that are likely to impact primary therapy in ovarian cancer. We summarized the objectives and the available data from these trials.

      Results

      A total of 12 potentially practice-changing, randomized phase III trials in front line ovarian cancer were identified in which a biologic therapy was added to primary chemotherapy and/or was used in the maintenance setting. These trials included PARP inhibitors (PARPi), anti-angiogenic agents, immuno-oncology agents, and combinations of these agents. Of the 12 trials, 10 are ongoing, one was terminated for futility, and one has been recently reported. All of these trials emphasize the use of maintenance targeted therapy. In addition, 7 randomized phase III trials utilizing hyperthermic intraperitoneal chemotherapy (HIPEC) were identified in the setting of upfront ovarian cancer treatment.

      Discussion

      There are multiple ongoing trials in primary ovarian cancer. These trials investigate PARPi, anti-angiogenic agents, immuno-oncology agents, combinations of these agents, and HIPEC. Many of these trials will mature within the next several years and are likely to change the primary treatment of women with ovarian cancer.

      Keywords

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      Article info

      Publication history

      Published online: February 12, 2019
      Accepted: February 5, 2019
      Received in revised form: February 3, 2019
      Received: December 23, 2018

      Identification

      DOI: https://doi.org/10.1016/j.ygyno.2019.02.008

      Copyright

      © 2019 Elsevier Inc. All rights reserved.

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