IT has been a breakthrough for the treatment of many tumour types, nevertheless it’s use in GM remains an area of ongoing clinical research. Early evidence suggests that IT treatment may sensitize to subsequent CTx. Our aim was to investigate the efficacy of pre-and post-IT CTx in a cohort of GM.
From 2014 to 2017, 60 GM pts were treated with IT in phase I/II trials at Vall d´Hebron Hospital. Data was retrospectively collected from those pts who received Ctx pre- and post-IT. Endpoints: Progression free survival (PFS), clinical benefit rate (CBR) at 6 months (m) and overall response rate (ORR).
A total of 28 (47%) pts (18 ovarian cancer [OC], 8 cervical cancer [CC] and 2 endometrial cancer [EC]) with median age of 53 (31-77), ECOG 0-1 (95%) and 2 median (1-5) pre-IT CTx lines were identified. IT was single agent PD1/L1 inhibitor in 46% of cases, the remaining receiving a combination of IT drugs. Median PFS on IT was 3.0m (2.0-5.3), CBR was 36% and ORR 10%. Platinum-based CTx was given to 83% of the patients pre-IT and 50% post-IT. The table summarizes clinical endpoints stratified by tumor type. Of note, 2 OC pts had longer PFS with platinum-based Ctx post-IT compared to pre-IT (15.9 vs 5.4 m and 21.4 vs 16.5 m). Such pattern was not observed in any pt with CC or EC. There was no association between benefit on IT and pattern of response to post-IT CTx.
A significant proportion of heavily pretreated GM pts are still treated with CTx after failure of IT. Although limited by sample size, our study did not show signals of improved sensitivity to CTx post-IT. GM pts retained the potential to respond to subsequent CTx. Further studies are needed to define the optimal timing of IT and to define potential predictors of improved CTx benefit.Table: 988P
Clinical endpoints for Ctx before and after IT
|OC (n = 18)||CC (n = 8)||EC (n = 2)|
|CTx pre||IT||CTx post||CTx pre||IT||CTx post||CTx pre||IT||CTx post|
|Median PFS (95% CI) months||9.62 (7.8-11.4)||3.43 (1.9-12.4)||8.2 (2.97-NA)||8.75 (6-NA)||3 (2.07-NA)||1.47 (1.03-NA)||11.33 (6.93-NA)||4.67 (2.63-NA)||2.42 (1.13-NA)|
Clinical trial identification
Legal entity responsible for the study
Vall d´Hebron Institute of Oncology (VHIO).
Has not received any funding.
E. Garralda: Advisory role: Roche, NeoMed Therapeutics, Ellypses Pharma. A. Oaknin: Advisory boards: Roche, AstraZeneca, PharmaMar, Clovis Oncology, Tesaro; Support for travel or accommodation: Roche, AstraZeneca, PharmaMar. All other authors have declared no conflicts of interest.