Dr. Wenham on the Role of ADCs in Ovarian Cancer

Supplements And Featured Publications, The Emerging Landscape & Novel Biomarkers in Ovarian Cancer, Volume 1, Issue 1

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Robert Wenham, MD, MS, FACOG, FACS, discusses the role of antibody-drug conjugates in ovarian cancer.

Robert Wenham, MD, MS, FACOG, FACS, gynecologic oncologist, chair, the Gynecologic Oncology Program, Moffitt Cancer Center, discusses the role of antibody-drug conjugates (ADCs) in ovarian cancer.

The underlying thought behind ADCs is compelling, since the agents can target biomarkers expressed only on cancer cells before delivering a payload to attack the cancer and preserve health cells, Wenham says. As the technology behind ADCs has improved, they have become more realistic options for use in ovarian and other cancers, Wenham adds.

In ovarian cancer, the ADC mirvetuximab soravtansine has been evaluated for patients with folate receptor alpha–high, platinum-resistant ovarian cancer. FRα is an ideal target since it is overexpressed in many patients with ovarian cancer, Wenham explains.

Ongoing clinical trials in ovarian cancer are exploring a variety of combination therapies, including platinum-based chemotherapy combinations, Wenham continues. Combinations examining platinum with anti-VEGF and immunotherapy are being evaluated to see if they can become viable options in ovarian cancer, Wenham adds. Moreover, additional ADCs are being explored as single agents and in various combinations, Wenham explains. Although it is unknown which ADC target will be the most successful for ovarian cancer, it is hoped that several will be found through future trials, Wenham says.

Regarding PARP inhibitors in ovarian cancer, there have been an abundance of data favoring patients harboring BRCA mutations, Wenham emphasizes. The phase 3 SOLO2 trial (NCT01874353) investigated olaparib (Lynparza) vs placebo as maintenance therapy for patients who had a complete or partial response to platinum-based chemotherapy, and it demonstrated an overall survival benefit with olaparib, Wenham says. Various therapies are being explored to attempt to overcome PARP resistance and make more patients respond, Wenham continues.

Considering the emergence of ADCs and PARP inhibitors, the importance of biomarker testing has been amplified for patients with ovarian cancer, Wenham explains. By identifying BRCA mutations or homologous recombination repair deficiency, more targeted therapies can be selected, and more than half patients with ovarian cancer will test positive for these biomarkers, Wenham concludes.

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