Opinion
Video
Single-Agent Vs Combination Regimens
Author(s):
Explore the latest advancements in ovarian cancer treatment, focusing on combination therapies and innovative approaches for platinum-resistant patients.
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:
- “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.”
- “Unless something’s truly synergistic—which, newsflash—nothing is. Synergy is not a thing clinically. It’s a thing in mice.”
- “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.”
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