Evolving Treatment Landscape in Platinum-Resistant Ovarian Cancer

Rachel N. Grisham, MD, of Memorial Sloan Kettering Cancer Center, and Ritu Salani, MD, MBA, of the David Geffen School of Medicine at UCLA, open their discussion of platinum-resistant ovarian cancer by reviewing how far treatment has come since the AURELIA trial, which Salani notes is more than a decade old and established bevacizumab added to weekly paclitaxel, liposomal doxorubicin, or topotecan. Salani describes how tumor profiling and immunohistochemistry testing opened the door to new options, starting with mirvetuximab soravtansine for tumors expressing folate receptor alpha (FRα), which improved both progression-free a;nd overall survival compared with single-agent chemotherapy. She then highlights two approvals this year, pembrolizumab with weekly paclitaxel with or without bevacizumab, and relacorilant with nab-paclitaxel, both of which improved progression-free and overall survival against their control arms. Salani cautions that several of these agents rely on microtubule inhibition, so a patient's prior treatments and lingering side effects should guide which option comes next.