Highlights
- •Median OS from 1st treatment after immunotherapy was 18.3 months in heavily pre-treated ovarian cancer patients.
- •OS after immunotherapy was favorable in all, including those who did not derive clinical benefit from immunotherapy.
- •Many patients were re-challenged with platinum-based regimens after immunotherapy with promising durations of therapy.
- •Bevacizumab was used in 59% of women after immunotherapy and increased duration of therapy.
Abstract
Objectives
Immune checkpoint inhibitors (ICIs) have modest activity in ovarian cancer (OC), yet
little is known about their effects on subsequent treatment. Preclinical studies suggest
immunotherapy may enhance response to chemotherapy. We sought to evaluate the impact
of ICIs on subsequent therapies and survival in recurrent OC.
Methods
A retrospective review was conducted to identify women with recurrent OC who received
ICI from 01/2013 to 5/2017 and ≥1 subsequent treatment. Treatment duration after ICI
was calculated using time-to-event analysis. Kaplan-Meier survival analysis and Cox
proportional hazards models were used to calculate overall survival (OS) from first
treatment after ICI and to assess survival differences by clinical benefit from ICI,
defined by long (≥24 weeks) versus short (<24 weeks) ICI treatment duration.
Results
Of 79 evaluable women identified, 66 (84%) had platinum-resistant OC. Median age at
diagnosis was 57 years. Median time from diagnosis to ICI was 39.7 months, with median
of 4 prior treatments (range, 1–12). Median number of treatments after ICI was 2 (range,
1–8). Median duration of first-line treatment after ICI was 3.7 months (95% CI, 2.9–6.0)
and declined with each subsequent line. The most common therapies after ICI were taxanes,
platinum-based regimens, and pegylated liposomal doxorubicin. Bevacizumab was used
in 47 women (59%). Median OS after ICI was 18.3 months (95% CI, 11.8–22.7) and did
not differ between long versus short ICI.
Conclusions
In this heavily pretreated population of patients with recurrent OC, therapies after
ICI resulted in promising survival, suggesting that ICI may improve efficacy of subsequent
chemotherapy.
Keywords
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Article info
Publication history
Published online: August 14, 2019
Accepted:
August 3,
2019
Received in revised form:
July 30,
2019
Received:
April 28,
2019
Identification
Copyright
© 2019 Elsevier Inc. All rights reserved.
