Activity

This is a recent treatment consultation we arranged for a stage 4 ovarian cancer patient. Bottom line, the latest most effective treatments seem to be a combination of immune therapy with a PARP inhibitor therapy. https://en.wikipedia.org/wiki/PARP_inhibitor – Get your free consultation on the WeHeal home page to find the most advanced treatments available for your case.

From your Caris reports, I see that your tumors are PD-L1 positive. It would make sense to try checkpoint immune inhibitors if you haven’t already had them.

Single-agent immunotherapy such as nivolumab (anti-PD-1) has demonstrated a modest response rate of 15% in PD-L1–positive platinum-resistant ovarian cancer. Recently, results of KEYNOTE-100 (NCT02674061) study showed that the overall response rate (ORR) with pembrolizumab (anti-PD-1) in patients with advanced recurrent ovarian cancer was 9% and was higher in patients with PD-L1 expression: 14% with a combined positive score ≥1 and 25% with a composite positive score of ≥10.

Since you also carry the BRCA1 mutation, it would also make sense to investigate PARP inhibitors in combination with immunotherapy. For example, Niraparib (a PARP inhibitor), has shown efficacy in patients with platinum-resistant/refractory ovarian cancer when in combination with pembrolizumab (anti-PD-1). Data from the recurrent ovarian cancer cohort of a recent trial showed an objective response rate of 25% in the 60 evaluable patients. The combination was also well-tolerated by patients. Please see: https://www.onclive.com/conference-coverage/sgo-2018/pembrolizumab-plus-niraparib-shows-promise-in-ovarian-cancer

Additionally, findings from the phase II MEDIOLA trial evaluating the combination of the PARP inhibitor olaparib and the anti-PD-L1 inhibitor durvalumab (Imfinzi) demonstrated a 72% ORR in patients with relapsed, platinum-sensitive, BRCA-mutated ovarian cancer. So, this approach of combining of anti-PD-1/L1 immune agent with another PARP inhibitor may be suitable for you. Please discuss this option with your treating team.