Promising Treatments for Pelvic Cancers
DON DIZON: Hi. Don Dizon. I’m a professor of medicine and professor of surgery at Brown University, and I treat pelvic cancers. And I’m here at ASCO ’23. And one of the studies that was presented was called the SHAPE Trial, and it looked at people presenting with early cervical cancer. This was disease that was limited to cervix– not very big.
And the approach is typically a very complicated surgical procedure that you need specialized training to do called a radical hysterectomy, where they not only take the cervix and the uterus, but the surgery goes out to the pelvic sidewalls. And it can be a very complicated procedure with perioperative complications. But if you did not have cervical cancer, the standard procedure if you need to have your uterus removed is just a simple hysterectomy. So that’s just removing the cervix and the uterus and not doing this complicated procedure that extends to the pelvic area and the side wall.
This study tested that simpler procedure versus the standard radical procedure and ultimately showed that at three years, the survival outcomes were the same and that quality of life was better with a simple hysterectomy, particularly as it related to sexual quality of life.
DON DIZON: Hi, I’m Don Dizon. I’m a professor of medicine and professor of surgery at Brown University. And I treat pelvic cancers. One of the studies presented at ASCO 23 was the overall survival results if you add a checkpoint inhibitor to the treatment of metastatic cervical cancer.
In this study, women with cervical cancer that had gone somewhere else or had metastasized, were randomly assigned to standard treatment with chemotherapy with or without a drug called bevacizumab, which blocks a specific protein called vascular endothelial growth factor with or without a checkpoint inhibitor called pembrolizumab.
And these data, which are updated analyses shows, if we added pembrolizumab to that standard two-drug or three-drug combination, we improved overall survival by about a year. So these data truly suggest, where it’s available, chemotherapy with pembrolizumab plus or minus the use of bevacizumab is the standard of care for people living with metastatic cervical cancer.
DON DIZON: This is Don Dizon. I’m a professor of medicine and professor of surgery at Brown University, and I treat pelvic cancers.
One of the studies presented here at ASCO ’23 was called the MIRASOL trial, and this study took people with recurrent ovarian cancer whose disease had come back early after attempted treatment with a platinum and a taxane standard combination with, hopefully. The intent to cure them. So if the disease comes back early, usually around six months or less, that situation is called platinum resistance.
The MIRASOL trial took people with platinum-resistant ovarian cancer and treated them with a novel drug called mirvetuximab or standard chemotherapy. And this study showed overall survival benefits with this new drug, mirvetuximab, over standard of care chemotherapy, importantly, in a selected group of people whose tumors expressed a protein called folate receptor alpha. So again, for those people who had high-expressing folate receptor alpha ovarian cancer whose disease recurred early after chemotherapy, mirvetuxim
