(Ovarian Cancer) Is Opdivo + Avastin Effective?

On October 10, 2019, Joyce F. Liu published in JAMA Oncology the "Efficacy and Safety Results of Combined Anti-PD-1 Antibody Opdivo (nivolumab) Plus Avastin (bevacizumab) in Previously Treated, Relapsed/Refractory Ovarian Cancer Patients in a Phase II Clinical Trial."

In this Phase II clinical trial, previously treated, relapsed/refractory ovarian cancer patients (N=38) received biweekly Opdivo 240mg + Avastin 10mg/kg therapy until unexpected adverse events occurred. The primary endpoint was objective response rate, and secondary endpoints included progression-free survival and safety.

This trial was initiated because PD-L1-positive ovarian cancer patients have poor prognoses, and based on prior clinical trials, the objective response rates for anti-PD-1 antibodies Opdivo and Keytruda in relapsed ovarian cancer patients were 15% and 8% respectively, showing limited antitumor effects. Based on this background, the trial evaluated the efficacy of combined anti-PD-1 antibody therapy in previously treated patients.

Patient background:

• Median age: 64 years (range 57-68)
• Race: White 92.1%, Asian 5.3%
• Stage: Stage I 2.6%, Stage II 7.9%, Stage III 50.0%, Stage IV 34.2%
• BRCA gene: Mutant type 5.3%, Wild type 6.3%, Unknown 18.4%
• Prior treatment: 1 prior treatment 42.1%, 2 prior treatments 34.2%, 3 prior treatments 23.7%
• Prior Avastin treatment: Yes 65.8%, No 34.2%

The trial results were as follows: the primary endpoint objective response rate for all patients was 28.9%, 40.0% for platinum-sensitive patients, and 16.7% for platinum-resistant patients.

The median duration of response for all patients was 6.0 months, 5.6 months for platinum-sensitive patients, and 12.3 months for platinum-resistant patients. The median progression-free survival for all patients was 8.1 months, 9.4 months for platinum-sensitive patients, and 5.3 months for platinum-resistant patients.

Regarding safety, at least one adverse event occurred in 89.5% of patients, with grade 3 or higher adverse events occurring in 23.7%. The most commonly observed adverse events were fatigue (47.4%), headache (28.9%), myalgia (28.9%), elevated serum amylase (28.9%), elevated AST (26.3%), and hypertension (26.3%).

Based on the Phase II clinical trial results, Joyce F. Liu concluded: "Combined anti-PD-1 antibody Opdivo plus Avastin showed favorable antitumor effects in relapsed/refractory ovarian cancer patients, particularly in platinum-sensitive patients. Opdivo + Avastin has the potential to become a new treatment option for these patients."

Source: Assessment of Combined Nivolumab and Bevacizumab in Relapsed Ovarian Cancer

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Related Cancer Information

• Ovarian cancer