Expert Highlights ‘Practice-Changing’ Gynecologic Cancer Studies at ASCO

Ritu Salani, MD, spoke with CancerNetwork^® about studies presented at the 2023 American Society of Clinical Oncology (ASCO) Annual Meeting that have the most potential to impact clinical practice in the gynecologic cancer space.

Salani, the Gynecologic Oncology Fellowship Director at University of California Los Angeles Health and the Gynecologic Oncology editorial board member for the journal ONCOLOGY^®, highlighted several studies assessing checkpoint inhibitors in the treatment of endometrial cancer, including the phase 3 ENGOT-EN6-NSGO/GOG-3031/RUBY trial (NCT03981796), assessing dostarlimab-gxly (Jemperli) in patients with advanced/recurrent disease. The agent demonstrated benefit among patients with mismatch repair deficient (dMMR) disease.¹

Additionally, Salani discussed mirvetuximab soravtansine-gynx (Elahere) as a treatment that may become a standard option among patients with platinum-resistant ovarian cancer based on data from the phase 3 MIRASOL trial (NCT04209855).²

Transcript:

At least this year, we've had 2 major practice-changing abstracts or studies that were presented. The first thing in the endometrial cancer space was the addition of checkpoint inhibitors. We had the RUBY trial, which [assessed] dostarlimab, and the phase 3 NRG-GY018 trial [NCT03914612], which is looking at pembrolizumab in the same setting.^1,3 And although FDA approval has not [happened] yet, it is only a matter of time. And this will really benefit our patients, particularly those with mismatch repair deficient tumors.

The other one is the MIRASOL trial.² We're using [mirvetuximab soravtansine] pretty standardly in the platinum-resistant population. I think it will also be standard of care [considering its] toxicity profile. I think this should probably be one of the first options we explore in these patients, and I look forward to getting more information on earlier lines of therapy.

There's still a lot on the horizon. One important thing is that although we're making a significant impact on these patients, we may not be curing every patient, which is obviously our goal. [We are] thinking about where the next steps are and where the landscape is shifting to continue to enroll patients in clinical trials and be advocates for our patients as we continue to treat them on their cancer journey.

References

1. Powell MA, Hietanen S, Coleman RL, et al. Dostarlimab for primary advanced or recurrent (A/R) endometrial cancer (EC): outcomes by blinded independent central review (BICR) of the RUBY trial (ENGOT-EN6-NSGO/GOG-3031/RUBY). J Clin Oncol. 2023;41(suppl 16):5503. doi:10.1056/NEJMoa2216334
2. Moore KN, Angelergues A, Konecny GE, et al. Phase III MIRASOL (GOG 3045/ENGOT-ov55) study: mirvetuximab soravtansine vs. investigator’s choice of chemotherapy in platinum-resistant, advanced high-grade epithelial ovarian, primary peritoneal or fallopian tube cancers with high folate receptor-alpha (FRα) expression. J Clin Oncol. 2023;41(suppl 17):LBA5507. doi:10.1200/JCO.2023.41.17_suppl.LBA5507
3. Eksander RN, Sill MW, Beffa L, et al. Pembrolizumab plus chemotherapy in advanced endometrial cancer. N Engl J Med. 2023;388:2159-2170. doi:10.1056/NEJMoa2302312