Olvimulogene nanivacirepvec followed by platinum-based chemotherapy and bevacizumab appears effective in patients with platinum-resistant or -refractory ovarian cancer, according to research published in JAMA Oncology.
Olvimulogene nanivacirepvec is a modified oncolytic vaccinia virus-based therapy. Researchers tested this therapy in combination with chemotherapy and bevacizumab in ovarian cancer patients in the phase 2 VIRO-15 trial (ClinicalTrials.gov Identifier: NCT02759588).
The trial enrolled 27 patients with platinum-resistant (n=14) or platinum-refractory (n=13) ovarian cancer. Patients had received a median of 4 prior lines of therapy (range, 2-9).
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The patients received olvimulogene nanivacirepvec in 2 consecutive doses, followed by platinum doublet chemotherapy and bevacizumab. All but 1 patient received carboplatin doublet chemotherapy, and 1 patient received oxaliplatin doublet chemotherapy. Patients received a median of 6 cycles (range, 1-17) of chemotherapy, started a median of 6 weeks after olvimulogene nanivacirepvec.
Most patients (n=23) started bevacizumab along with the chemotherapy, but 4 patients started bevacizumab later. Six patients received oral cyclophosphamide and bevacizumab after platinum-based therapy.
The objective response rate (ORR) by RECIST 1.1 was 54% among all 24 evaluable patients. The ORR was 55% among patients with platinum-resistant disease and 54% among patients with platinum-refractory disease.
The median duration of response was 7.6 months, and the disease control rate was 88%.
The ORR by CA-125 was 85% among all 26 evaluable patients and 85% for both the platinum-resistant and platinum-refractory groups.
The median progression-free survival (PFS) was 11.0 months overall, 10.0 months in patients with platinum-resistant disease, and 11.4 months in patients with platinum-refractory disease. The 6-month PFS rate was 77%.
The median overall survival was 15.7 months overall, 18.5 months in patients with platinum-resistant disease, and 14.7 months in patients with platinum-refractory disease.
The most common treatment-related adverse events were pyrexia (63%), abdominal pain (51.9%), and nausea (48.1%). There were no treatment discontinuations or deaths due to treatment-related adverse events.
Olvimulogene nanivacirepvec followed by platinum-based chemotherapy and bevacizumab “demonstrated promising ORR and PFS and clinical reversal of platinum resistance and refractoriness, with manageable toxic effects,” the researchers wrote.
They noted that a phase 3 trial is now underway. In this trial, researchers will compare olvimulogene nanivacirepvec plus platinum doublet chemotherapy and bevacizumab to platinum doublet chemotherapy and bevacizumab only in platinum-resistant or -refractory ovarian cancer (ClinicalTrials.gov Identifier: NCT05281471).
Disclosures: This research was supported by Genelux Corporation. Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.
Reference
Holloway RW, Mendivil AA, Kendrick JE, et al. Clinical activity of olvimulogene nanivacirepvec–primed immunochemotherapy in heavily pretreated patients with platinum-resistant or platinum-refractory ovarian cancer: The nonrandomized phase 2 VIRO-15 clinical trial. JAMA Oncol. Published online May 25, 2023. doi:10.1001/jamaoncol.2023.1007
