Princess Margaret Cancer Centre, UHN
Division of Medical Oncology and Hematology

Moderator of 1 Session

Session Type
Master Session
Date
09/30/2022
Session Time
04:00 PM - 06:25 PM
Room
Hall 501
Session Icon
Live
Session Description
This session is dedicated to innovations in ovarian cancer biology, surgery and treatment. Speakers in this session will cover the role of “biology” in clinical outcomes and potential for surgical decision making, timing and new approaches. With the growing interest in intraoperative treatments, a critical appraisal of HIPEC will be performed. The second part will discuss current and emerging systemic therapies in the first-line setting and how the ongoing trials may change clinical practice. Next, several “hot topics” in ovarian cancer will be presented, including the mechanisms of resistance to PARP inhibitors, front-line maintenance therapy as part of standard-of-care (SOC) for at least 50% of women with ovarian cancer and the new and very promising developmental therapies. To close this session dedicated to ovarian cancer, a debate on the role of surgery for relapsed disease from the US and European perspectives will be debated.

Presenter of 4 Presentations

PANEL 1: POTENTIAL IMPACT ON STANDARD OF CARE: REVIEW OF PENDING TRIALS (25 min) – moderated by Amit Oza

Session Type
Master Session
Date
09/30/2022
Session Time
04:00 PM - 06:25 PM
Room
Hall 501
Session Icon
Live
Presenter
Lecture Time
04:30 PM - 04:30 PM
Onsite or Pre-Recorded
Onsite

• Overcoming PARP resistance

Session Type
Master Session
Date
09/30/2022
Session Time
04:00 PM - 06:25 PM
Room
Hall 501
Session Icon
Live
Presenter
Lecture Time
04:54 PM - 05:06 PM
Onsite or Pre-Recorded
Onsite

SEMINAL ABSTRACT PRESENTATION: OVERALL SURVIVAL RESULTS FROM THE PHASE 3 ARIEL4 STUDY OF RUCAPARIB VS CHEMOTHERAPY IN PATIENTS WITH ADVANCED, RELAPSED OVARIAN CARCINOMA AND A DELETERIOUS BRCA1/2 MUTATION

Session Type
Plenary Session
Date
09/30/2022
Session Time
02:45 PM - 03:55 PM
Room
Hall 501
Session Icon
Live
Presenter
Lecture Time
03:03 PM - 03:08 PM
Onsite or Pre-Recorded
Onsite

Abstract

Objectives

Rucaparib significantly improved progression-free survival (PFS) vs chemotherapy (CT) in patients with relapsed, heavily pretreated, BRCA1/2-mutated ovarian carcinoma in ARIEL4 (NCT02855944; Kristeleit et al. Lancet Oncol. 2022;23:465-78). We present final overall survival (OS) and PFS on the subsequent line of therapy (PFS2) data.

Methods

Patients were randomized 2:1 to oral rucaparib 600 mg BID or CT. In the CT group, patients with platinum-resistant (progression-free interval [PFI] ≥1 to <6 months) or partially platinum-sensitive (PFI ≥6 to <12 months) disease received weekly paclitaxel; those with fully platinum-sensitive disease (PFI ≥12 months) received investigator’s choice of platinum-based CT (single-agent platinum or platinum doublet). Patients allocated to CT could cross over to receive rucaparib upon confirmed radiographic progression per RECIST. OS was a standalone secondary endpoint; PFS2 was exploratory.

Results

As of data cutoff, 14/233 (6%) rucaparib-group and 0/116 CT-group patients were ongoing on assigned study treatment; 80 (69%) patients crossed over to receive rucaparib. Overall, 313/349 (90%) patients received rucaparib from randomization or after crossover. Death events have occurred in 244 (70%) patients. Efficacy endpoints are presented in the Table. Rucaparib safety was consistent with previous reports.

igcs2022_oza_abs_ariel4 os_09may2022_clean.jpg

Conclusions

PFS2 did not significantly differ between treatment groups, while OS favored CT in the intent-to-treat (ITT) population. OS was similar between treatment groups amongst patients with platinum-sensitive disease; the difference in OS in the ITT population was driven by the platinum-resistant subgroup. The high rate of crossover confounded OS, highlighting important questions about PARP inhibitor sequencing in the treatment of advanced ovarian carcinomas.

Hide