Single-Agent Vs Combination Regimens

Video content is prompted by the following:

Single Agent Vs Combination Regimens in Platinum-Resistant Disease

Key Discussion Points:

• Established Combination Therapies
• Bevacizumab plus chemotherapy remains standard of care in platinum-resistant setting

• Weekly paclitaxel combined with bevacizumab increases response rates from 30% to 50%

• Many patients cannot receive bevacizumab due to contraindications (hypertension, bowel obstruction, extensive intestinal disease)
• Emerging Combination Approaches
• Ongoing trials examining new combinations (olvimulogene nanivacirepvec [olvi-vec] with chemotherapy, relacorilant, and abraxane)

• Bevacizumab with mirvetuximab showing promise in specific clinical situations

• Limited true synergistic combinations identified to date in clinical practice
• PICCOLO Trial Data
• Single-arm trial of approximately 80 patients with folate receptor alpha–high recurrent disease

• 52% response rate with mirvetuximab in platinum-sensitive patients after ≥2 lines of platinum

• Duration of response just under 8 months with approximately 50% having previously progressed on PARP inhibitors

Notable Insights:

1. “PICCOLO is our really first successful look at...replacing platinum with another agent. We’ve tried to do it in the past with a study called MITO8, which was pre-PARP...but it was ahead of its time.”
2. “Unless something’s truly synergistic—which, newsflash—nothing is. Synergy is not a thing clinically. It’s a thing in mice.”
3. “Sometimes you’re using combos, and you’re just using up medications together that you could sequence with less toxicity and probably more benefit to the patient.”