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Pills Show Promise for Recurrent Ovarian Cancer

Preliminary findings suggest this experimental treatment might slow disease

WebMD News from HealthDay

By Dennis Thompson

HealthDay Reporter

SATURDAY, May 31, 2014 (HealthDay News) -- A combination of two new pills may nearly double the length of survival for patients with recurrent ovarian cancer, according to preliminary clinical trial results.

The therapy combines the drugs olaparib and cediranib. It provided nearly 18 months of progression-free survival on average, as opposed to nine months' survival with olaparib treatment alone, said Dr. Joyce Liu, a gynecologic oncologist at Dana-Farber Cancer Institute in Boston.

Liu was scheduled to present the study findings Saturday at the American Society of Clinical Oncology meeting in Chicago.

The results "compare favorably to what you'd see in chemotherapy," Liu said. This raises the possibility that this drug combination "might offer a non-chemotherapy alternative for the treatment of ovarian cancer," she said. Patients could swallow pills rather than go through intravenous chemo treatment.

As many as four out of five women with aggressive ovarian cancer experience a relapse after chemotherapy, the researchers said. When the cancer returns, it is more likely to have spread to other parts of the body and to have developed resistance to chemotherapy.

Because of this, researchers have been exploring alternate treatments for ovarian cancer that can overcome resistance to chemotherapy.

Olaparib works by targeting an enzyme called PARP that repairs DNA damage in cells and, if inhibited, could cause cancer cells to die. Cediranib blocks the growth of blood vessels in a tumor, starving the cancer of the nutrition and oxygen it needs to survive.

Both drugs are awaiting U.S. Food and Drug Administration approval, Liu said. And as with most studies presented at meetings, the findings should be considered preliminary until published in a peer-reviewed medical journal.

The U.S. National Cancer Institute-funded trial involved 90 women with aggressive ovarian cancer that returned after chemotherapy. Participants were randomly assigned to receive treatment with olaparib alone or a combination of olaparib and cediranib. All had cancers that responded to platinum-based chemotherapy.

Tumors shrank more dramatically during combination therapy -- 80 percent compared to 48 percent for patients who only received olaparib, the researchers found.

The combination treatment delayed disease progression, with a median progression-free survival of 17.7 months, the researchers said. Past trials of standard chemotherapy for platinum-sensitive patients have demonstrated median progression-free survival times between eight and 13 months, they noted.

Five patients in the combination arm and two patients in the olaparib-alone arm had a complete remission, the findings showed.

"If you combine these two agents, we saw significantly improved activity," Liu said.

The drugs seem to be synergistic, meaning they make each other more effective when used together.

It's not clear how the drugs work in tandem, Liu said. One theory is that by depriving cancer cells of oxygen using cediranib, they are more vulnerable to DNA damage left unrepaired by olaparib. Another is that both might work to retard the growth of blood vessels to the tumor.

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