Combination Treatment Increases Quality of Life for Patients With Ovarian Cancer

A novel regiment consisting of a combination of Keytruda (pembrolizumab), Avastin (bevacizumab) and oral metronomic cyclophosphamide shows efficacy, safety and better quality of life in patients with recurrent platinum-sensitive, platinum-resistant or refectory epithelial ovarian, fallopian tube or primary peritoneal cancer, according to data published in JAMA Oncology.

Treatment options for ovarian cancer are often limited in clinical benefit and negatively affect the patient’s quality of life, leading to an unmet need for a tolerable therapy. This study consisted of 40 women who had measurable recurrent ovarian cancer.

The patients received 200 milligrams of Keytruda and 15 milligrams per kilogram of Avastin every three weeks, in addition to a daily dose of 50 milligrams of oral metronomic cyclophosphamide. They received this treatment until there was disease progression, toxic effects or study withdrawal.

Of the 40 enrolled, 39 patients discontinued treatment because of progressive disease and requested treatment break and withdrawal, but all 40 were evaluated for safety and efficacy data.
Measuring objective responses (the proportion of patients who had a complete or partial response to treatment) and progression-free survival (length of time during and after cancer treatment that a patient is alive but the disease does not get worse) were the main goals of the study. Other outcomes included frequency and severity of events, duration of response, overall survival, treatment response and quality of life.

Three participants had complete responses, 16 had partial responses and 19 had stable disease in response to treatment. The objective response rate was 47.5%, clinical benefit was seen in 38 participants and durable response was seen in 10. The median progression-free survival for the entire study population was 10 months.

The patients were given quality-of-life questionnaires at the beginning of the study and then again at three and six months into treatment. During the trial, global and physical functioning scores remained high, with body image, emotional functioning and social functioning all having improved scores.

This combination of Keytruda with Avastin and oral cyclophosphamide gave positive results, as it was well tolerated by patients.

The results, according to the study authors, show the novel therapy may be a future treatment option for these patients.