Immunotherapy's Great Potential for Ovarian Cancer
Immunotherapy refers to treatment that uses an individual’s immune system to tackle diseases such as cancer. It can be done by providing immune system components or triggering the body’s own immune system to function more effectively and efficiently at eliminating cancer cells. Within the last few years, research on immunotherapy for treating several types of cancer has shown promising results, especially in the field of ovarian cancer. Experts believe that immunotherapy could prove to be an effective treatment for this type of cancer, as well as several others, including lung cancer and kidney cancer. In comparison to chemotherapy, immunotherapy presents fewer side effects for cancer patients and this is enough for researchers to continue their clinical trials on immunotherapy agents in the field of treatment for ovarian cancer.
Immunotherapy is currently behind in ovarian cancer
“Immunotherapy is an emerging treatment in all solid tumors and is approved in many: head and neck, bladder, melanoma, lung, and kidney, but not ovarian cancer. Five randomized phase III trials are ongoing of avelumab and atezolizumab (Tecentriq), combining checkpoint inhibitors with chemotherapy either in the frontline setting or in platinum-resistant patients, or in the relapse of platinum-sensitive patients. We are excited about these trials. We combine immunotherapy agents with chemotherapy for 2 reasons. Tumor-infiltrating lymphocytes (TILs) are not present in about 40% of newly diagnosed epithelial ovarian cancers, and without TILs, checkpoint inhibitors are not likely to work. PD-L1 expression is also not there in about 30% of patients. We are hoping that by adding chemotherapy to checkpoint inhibition, we will be able to cause immunogenic cell death. As the cells die as a result of the chemotherapy, it will auto-immunize the patient, and then checkpoint inhibitors will help the patient’s immune system fight the cancer,” said Bradley J. Monk, professor and director of the Division of Gynecologic Oncology at Creighton University School of Medicine at St. Joseph’s Hospital and Medical Center in Phoenix.
A study is underway
One particular study, known as JAVELIN Ovarian 200, is currently underway in phase III development. It is a study of Bavencio alone or combined with pegylated liposomal doxorubicin vs. pegylated liposomal doxorubicin alone in patients with platinum-resistant/refractory ovarian cancer.
Too soon to tell?
Checkpoint inhibitors in combination with PARP inhibitors are also arising researchers’ interests. Still, Johnathon Ledermann, professor of medical oncology at UCL Cancer Institute in London, stated that it is too early to tell whether immunotherapy, combined with PARP inhibitors or chemotherapy, could prove to be an effective type of treatment for ovarian cancer. “However, the first combination with chemotherapy, the JAVELIN Ovarian 200 study, has finished recruitment. We are very eager to hear those data, but that will be probably another nine to 12 months. That will be the first point in this combination with chemotherapy. Combinations with other drugs, such as Avastin or PARP inhibitors, are way behind. Although some randomized trials have started, it is going to be a long time before we know the activity of those drugs,” he said.
Read on to learn more about this research and what it means for the future of ovarian cancer.