Elizabeth M. Swisher, MD, a co-leader of the Breast and Ovarian Cancer Research Program at Seattle Cancer Care Alliance, a professor in the Division of Gynecologic Oncology at the University of Washington School of Medicine, director of the Division of Gynecologic Oncology at UW Medicine, and affiliate investigator in the Clinical Research Division at Fred Hutchinson Cancer Research Center, discusses the limitations of homologous recombination deficiency (HRD) as a biomarker in ovarian cancer. 

 Updated findings from the phase III VELIA study demonstrated extended progression-free survival with veliparib (ABT-888) in combination with chemotherapy in patients with BRCA wild-type, high-grade serous carcinoma, irrespective of HRD status. 

HRD appears to be a predictive biomarker of response for other PARP inhibitors in this patient population, says Swisher. 

Veliparib is thought to potentiate the effects of chemotherapy, explains Swisher. As such, veliparib may function in a different way than when it is utilized alone, says Swisher. 

  The findings from VELIA require further investigation to determine why patients seem to respond well with this combination, regardless of HRD status, concludes Swisher.

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Elizabeth M. Swisher, MD, discusses the limitations of homologous recombination deficiency as a biomarker of response in ovarian cancer based on findings from the phase III VELIA trial.

Dr. Swisher on the Limitations of HRD as a Biomarker in Ovarian Cancer

Elizabeth M. Swisher, MD, a co-leader of the Breast and Ovarian Cancer Research Program at Seattle Cancer Care Alliance, a professor in the Division of Gynecologic Oncology at the University of Washington School of Medicine, director of Division of Gynecologic Oncology at UW Medicine, and affiliate investigator in the Clinical Research Division at Fred Hutchinson Cancer Research Center, discusses the implications of the phase III VELIA/GOG-3005 trial in ovarian cancer.

Updated findings from the trial, which were scheduled to be presented during the 2020 SGO Annual Meeting, showed that veliparib (ABT-888) plus chemotherapy led to extended progression-free survival in 

 wild-type patients with high-grade serous carcinoma regardless of homologous recombination deficiency status.

Additionally, data from the trial demonstrated that the combination was well-tolerated. As such, this regimen is expected to become another frontline maintenance therapy option in this patient population, says Swisher. Moreover, patients who do not respond well to platinum-based chemotherapy may be eligible for this treatment.

It is difficult to compare veliparib/chemotherapy with other frontline maintenance options, says Swisher. Ultimately, these findings are encouraging as they suggest that patients who are platinum-refractory or platinum-resistant may derive benefit from veliparib/chemotherapy. However, additional investigation is needed to flesh out when to utilize this regimen over another, concludes Swisher.

Elizabeth M. Swisher, MD, discusses the implications of the phase III VELIA/GOG-3005 trial in ovarian cancer.

Dr. Swisher on the Implications of the VELIA Trial in Ovarian Cancer

Elizabeth M. Swisher, MD, a co-leader of the Breast and Ovarian Cancer Research Program at Seattle Cancer Care Alliance, a professor in the Division of Gynecologic Oncology at the University of Washington School of Medicine, director of Division of Gynecologic Oncology at UW Medicine, and affiliate investigator in the Clinical Research Division at Fred Hutchinson Cancer Research Center, discusses how the phase III VELIA/GOG-3005 trial compares with other trials examining up-front maintenance therapy in ovarian cancer.

Updated results from the VELIA trial presented during the 2020 SGO Annual Meeting demonstrated an advantage to using veliparib (ABT-888) in combination with chemotherapy in the treatment of patients with BRCA wild-type, high-grade serous carcinoma, says Swisher. The veliparib combination resulted in extended progression-free survival in this patient population, and this benefit was seen irrespective of homologous recombination deficiency.

In the trial, patients were assigned to a control arm comprised of carboplatin plus paclitaxel with placebo followed by placebo as maintenance or veliparib plus chemotherapy followed by veliparib monotherapy as maintenance therapy.

The VELIA trial stands apart from other trials that are also examining up-front maintenance therapy because there was a phase of the trial where the PARP inhibitor was combined with chemotherapy, says Swisher. Additionally, the patient population included in the VELIA trial differed from other trials in that they were enrolled upon diagnosis without knowledge of whether they were sensitive to platinum-based chemotherapy, adds Swisher. Patients included in other trials were enrolled after they had responded to platinum.

The VELIA trial also included a small number of patients who had primary platinum-refractory disease, a population that would not be eligible for enrollment in other frontline maintenance trials, concludes Swisher.

View more from the 2020 SGO Annual Meeting

Elizabeth M. Swisher, MD, discusses how the phase III VELIA/GOG-3005 trial compares with other trials examining up-front maintenance therapy in ovarian cancer.

Elizabeth M. Swisher, MD

Articles

Dr. Swisher on the Limitations of HRD as a Biomarker in Ovarian Cancer

Dr. Swisher on the Implications of the VELIA Trial in Ovarian Cancer

Dr. Swisher on How the VELIA Trial Stands Out in Ovarian Cancer Research