To further understand the key developments and research presented in the field of gynaecological oncology at ESMO 2023, we spoke with Dr Domenica Lorusso, Professor of Obstetrics and Gynaecology at the Fondazione Policlinico Universitario Agostino Gemelli – UCSC Italy.
In our interview, Dr Lorusso discuses the findings and clinical impact of two stand out trials; the KEYNOTE-A18 (NCT04221945), a phase 3 study investigating pembrolizumab plus chemotherapy in high-risk locally advanced cervical cancer, and DUO-E (NCT03737643), a phase 3 study exploring durvalumab followed by maintenance durvalumab ± olaparib in first-line treatment for newly diagnosed advanced or recurrent endometrial cancer.
Associated abstracts:
LBA38 – Pembrolizumab plus chemoradiotherapy for high-risk locally advanced cervical cancer: A randomized, double-blind, phase III ENGOT-cx11/GOG-3047/KEYNOTE-A18 study
LBA41 – Durvalumab (durva) plus carboplatin/paclitaxel (CP) followed by maintenance (mtx) durva ± olaparib (ola) as a first-line (1L) treatment for newly diagnosed advanced or recurrent endometrial cancer (EC): Results from the phase III DUO-E/GOG-3041/ENGOT-EN10 trial
Disclosures: Domenica Lorusso has acted as consultant for; Astra Zeneca, Clovis Oncology, Genmab, GSK, Immunogen, MSD, Novartis, Pharmamar and Seagen; received grant/research support from; Astra Zeneca, Clovis Oncology, Genmab, GSK, Immunogen, Incyte, MSD, Novartis, Pharmamar, Roche, and Seagen; acted on the advisory board for; Astra Zeneca, Clovis Oncology, Corcept, Genmab, GSK, Immunogen, MSD, Novartis, Oncoinvest, Pharmamar, Seagen and Sutro; been a speaker bureau participant with; Astra Zeneca, Clovis Oncology, Corcept, Genmab, GSK, Immunogen, MSD, Novartis, Oncoinvest, Pharmamar, Seagen and Sutro.
Support: Interview and filming supported by Touch Medical Media Ltd. Interview conducted by Gina Furnival.
Filmed in coverage of the ESMO 2023
Click here for more content on gynaecological cancer & for further ESMO 2023 highlights visit here.
Transcript
I’m Domenica Lorusso and a Professor of Obstetrics and Gynaecology at the Catholic University of Sacred Heart, Milan.Â
There were two top highlights. The first one was in, cervical cancer where for the first time in 25 years we saw an achievement in the setting of locally advanced cervical cancer. In particular, the KEYNOTE-A18 study, which demonstrated that the combination of pembrolizumab + concurrent chemoradiation and brachytherapy significantly increased the progression free survival in a population of locally advanced high-risk cervical cancer patients. The other ratio for progression free survival was 0.70 suggesting a 30 percent reduction in the risk of progression, and that the iteration for overall survival was 0.73, but overall survival data are not yet mature, referring to only 43 percent of the events, so we have to wait for more mature survival data but the trend in favour of overall survival is promising. This is a huge achievement because chemoradiation has been the standard of care for 25 years in cervical cancer. The second huge treatment was in endometrial cancer, where for the first time we saw data with PARP inhibitors in endometrial cancer.
The DUO-E trial reported that the combination of platinum-based chemotherapy plus immunotherapy plus a PARP inhibitor provided 45 percent reduction in the risk of progression with respect to chemotherapy alone, in a population of advanced of recurrent endometrial cancer. With a molecular profile, proficient for microsatellite instability. Also, in this case, overall survival data are not yet mature, but the trend towards an increase in overall survival is also reported in this population. So potentially, I expected that we hear quite soon the reimbursement of the drug for these patients.
