Drug combination delays worsening of disease in women with recurrent ovarian cancer

For many women with ovarian cancer that has recurred after initial treatment, a two-drug combination can significantly extend the time that the disease is kept in check, a phase 2 clinical trial led by Dana-Farber Cancer Institute investigators and supported by the National Cancer Institute shows.

In a report on the trial in the online edition of The Lancet Oncology, researchers compared the drugs cediranib and olaparib, versus olaparib alone, in their ability to stall the advance of ovarian cancer in women with a recurrent form of the disease that responds to platinum-based chemotherapy agents. The study enrolled 90 patients with platinum-sensitive, recurrent ovarian cancer. Half were randomly assigned to receive cediranib and olaparib (both in pill form), and half to receive olaparib alone. The investigators found that the median period before the disease began to worsen – known as progression-free survival (or PFS) – was nearly 18 months for women receiving the combined therapy, versus nine months for those receiving olaparib alone.

The results were even more striking when researchers compared two subsets of the study participants. In women whose ovarian tumors lacked mutations in the genes BRCA1 or BRCA2, the median PFS for those treated with the combination therapy was 16.5 months, vs. 5.7 months for those treated with olaparib only. In women whose tumors did carry BRCA mutations, the median PFS for the combined-therapy group was 19.4 months, vs. 16.5 for the olaparib-alone group.

Severe side effects to treatment, though relatively rare, were more common in the cediranib-and-olaparib group, with fatigue, diarrhea, and hypertension the most frequent problems.