Adding Tecentriq to Chemotherapy-Avastin Regimen Does Not Improve Efficacy in Ovarian Cancer

Adding Tecentriq (atezolizumab) to a platinum-based chemotherapy regimen and Avastin (bevacizumab) did not improve progression-free survival or overall survival in patients with newly diagnosed stage 3 or 4 ovarian cancer, according to data published in Journal of Clinical Oncology.

Researchers enrolled 1,301 patients with newly diagnosed stage 3/4 ovarian cancer who had either undergone primary cytoreductive surgery (removing cancerous tissue in the abdomen) with macroscopic residual disease (cancer cells that remain after attempting to remove) or planned to receive neoadjuvant chemotherapy and interval surgery. Of the patients in this study, 784 (60%) had PD-L1-positive tumors.

• Patients were assigned either three weekly cycles of Tecentriq at 1,200 mg (651 patients) or placebo (650 patients. Both groups also received paclitaxel plus carboplatin (first day of cycles 1 through 6) and 15 mg/kg of Avastin on (the first day of cycles 2 through 22).

Researchers assessed factors including progression-free survival (time during and after treatment when the patient lives without disease progression) and overall survival (time from diagnosis or treatment start when patients are alive).

Median progression-free survival was 19.5 months with Tecentriq and 18.4 months with placebo. In patients with a positive PD-L1 expression, median progression-free survival was 20.8 months in patients assigned Tecentriq compared with 18.5 months in those assigned placebo.

Although it was too early to determine specific findings related to overall survival, preliminary results demonstrated that Tecentriq did not show a significant benefit in this area.

Side effects considered severe or worse were more frequent in the Tecentriq group than the placebo (79% versus 73%). The most common severe or life-threatening side effects included neutropenia (low count of white blood cells called neutrophils; 21% in both groups), high blood pressure (18% with Tecentriq and 20% with placebo) and anemia (12% in both groups).

“Currently, there is no evidence to support using immune checkpoint inhibitors in newly diagnosed (ovarian cancer),” the study authors wrote. “Insights from this trial should be considered for further research. Combining observations from this large trial with plausible biologic hypotheses will enable us to embrace specific trial designs in more focused, selected populations and settings.”

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