Nivolumab/bevacizumab Combo Promising in Relapsed Ovarian Cancer

By Reuters Staff

October 19, 2019

NEW YORK (Reuters Health) - The combination of nivolumab and bevacizumab may be an effective treatment strategy for women with relapsed ovarian cancer, according to results of a phase 2 clinical trial.

"To date, single-agent programmed cell death 1 protein 1 (PD-1)/programmed death ligand 1 (PD-L1) immune checkpoint blockade has shown limited activity in recurrent epithelial ovarian cancer," Dr. Joyce Liu from Dana-Farber Cancer Institute in Boston and colleagues note in JAMA Oncology, online October 10. "Combination strategies of PD-1/PD-L1 inhibition with antiangiogenic therapy have the potential for synergistic activity through modulation of the microenvironment and represent a potential therapeutic opportunity in this disease."

Their trial included 38 women (mean age, 63) - 20 with platinum-sensitive and 18 with platinum-resistant relapsed epithelial ovarian cancer. All of them had disease recurrence within one year of their last platinum-based therapy and had one to three lines of prior therapy. The women received nivolumab (240 mg IV) and bevacizumab (10 mg/kg IV) once every two weeks.

Eleven women had a confirmed response to the combination treatment therapy (objective response rate, 28.9%) and one additional response was unconfirmed. The objective response rate was better in platinum-sensitive (40.0%) than platinum-resistant (16.7%) tumors.

The median duration of response was six months and median progression-free survival was 8.1 months.

Women with platinum-resistant disease had a longer median duration of response than women with platinum-sensitive disease (12.3 months vs. 5.6 months) but shorter median progression-free survival (5.3 months vs. 9.4 months).

Thirty-four women (89.5%) had at least one treatment-related adverse event; in nine (23.7%), it was grade 3 or higher.

Of the 36 histologic samples available for PD-L1 testing, 22 (61.1%) had a PD-L1 tumor percentage less than 1 and 14 (38.9%) samples had a PD-L1 tumor percentage of 1 or greater. There were 10 responses among patients with PD-L1 tumor percentage less than 1 and two responses among patients among the PD-L1 tumor percentage of 1 or greater.

These results suggest that the nivolumab/bevacizumab combination is feasible, well tolerated and active in women with relapsed ovarian cancer, with greater activity in the platinum-sensitive setting, the authors conclude. They say further study of this combination is warranted in relapsed ovarian cancer.

This was an investigator-initiated study supported by Bristol-Myers Squibb, which provided study funding and nivolumab. Dr. Liu reported ties to the company.


JAMA Oncol 2019.