Dr. Matulonis on the Use of Immunotherapy in Recurrent Ovarian Cancer

Ursula A. Matulonis, MD, director, Gynecologic Oncology, Dana-Farber Cancer Institute, professor of medicine, Harvard Medical School, discusses the use of immunotherapy in patients with recurrent ovarian cancer.

On May 23, 2017, the FDA granted an accelerated approval to pembrolizumab (Keytruda) for the treatment of adults and pediatric patients with unresectable or metastatic, microsatellite instability-high (MSI-H) or mismatch repair deficient solid tumors that have progressed after prior treatment and who have no alternative treatment options. Although not specific to patients with gynecologic cancer, it represents an additional therapy for this patient subset.

MSI-H is seen more commonly in women with recurrent endometrial cancer than in women with recurrent ovarian cancer. As a result, most pathologists are not specifically testing for MSI-H status, explains Matulonis. However, many of the next-generation sequencing panels already account for MSI-H status. If a patient’s somatic tumor profile comes back with several mutations, it may be an indication that they are also MSI-H.