Recurrent Gynecologic Cancers: Meet the Next Wave of Promising Therapies

By Erin K. Crane, MPH, MD and R. Wendel Naumann, MD

At Levine Cancer Institute (LCI), we have some of the region’s best success rates for helping patients with gynecologic cancer achieve remission. But about 1 in 4 cervical cancer patients – and 8 in 10 ovarian cancer patients – will see their cancer come back.

Whereas many of these patients previously only had months to live, there’s now a ray of hope: LCI is offering a new wave of innovative clinical trials, including the first trial of an immunotherapy agent in combination with radiation and chemotherapy for newly diagnosed cervical cancer. It is hoped that this phase II trial will increase complete response rates and improve the cure rate for patients with locally advanced cervical cancer.

Checkpoint Inhibitors for Recurrent Cervical Cancer

When metastatic or recurrent cervical cancer progresses after chemotherapy, pembrolizumab is the best FDA-approved option – but only 10 to 15 percent of patients respond to this drug. We’re leading a Phase I trial that aims to improve on that by combining two checkpoint inhibitors, ipilimumab and nivolumab.

Ipilimumab helps the immune system attack cancer cells by blocking the CTLA-4 molecule and improving antigen presentation to the immune system. Nivolumab makes it harder for cancer cells to escape T cells by blocking the PD-1 protein.

Preliminary results suggest that this combination can yield much higher response rates than pembrolizumab, and trial participants have been referred to us from as far away as Georgia and Florida. Some of these patients have achieved stunning results, including one woman with metastatic disease who enrolled when she was about to enter hospice care. Almost two years later, she shows no evidence of disease.

Blocking Blood Vessels in Platinum-Resistant Cancer

We’re offering several clinical trials delivering hope against platinum-resistant cancer, including a Phase I trial of Navicixizumab, a monoclonal antibody that blocks blood vessels that feed tumors.

We recently presented an abstract at the European Society for Medical Oncology Congress that showed the drug has been effective against several cancers in preclinical models. Even better, 45 percent of heavily pretreated ovarian cancer patients responded to this drug in an earlier Phase I trial. We’re hopeful that our trial will yield even better results.

A Less Toxic Approach to Ovarian and Endometrial Cancers

One of our Phase I trials will test an innovative antibody-drug conjugate called STRO-002, which targets a receptor called folate receptor alpha. This receptor is a promising target because it’s commonly expressed on ovarian and endometrial cancers, but is highly restricted in healthy tissue.

Even better, STRO-002 is stable until it’s taken into the cancer cell. This gives us good reason think that STRO-002 could be more effective and far less toxic than today’s standard therapies.

Immunotherapy for Newly Diagnosed Ovarian Cancer

We’re especially excited to offer one of the first trials of immunotherapy as a front-line treatment for newly diagnosed gynecologic cancers. This Phase III trial combines a monoclonal antibody called atezolizumab with three standard agents: paclitaxel, carboplatin and bevacizumab. The goal is for atezolizumab to help obliterate more cancer cells during initial treatment and, in turn, reduce the chances of recurrence.

The trial is open to patients with Stage 3 or 4 ovarian, fallopian tube or primary peritoneal cancer.

The LCI Difference

LCI sees more gynecologic cancer patients than almost any other center in the region, and our deep clinical trials expertise means we can offer innovative therapies – including off-label drug uses – to patients who are running out of options. We’re eager to consult with you and develop a plan that gives your patients the best chance at longer, healthier lives.

For more information, or to make a referral, call 980-442-2200