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
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
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
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
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
"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.
Using both drugs together does increase side effects, most
commonly high blood pressure, fatigue and diarrhea, the researchers
said. For the most part, side effects were managed by treating the
symptoms or adjusting the dosage of the drugs, Liu said.
Dr. David Fishman is a gynecologic oncologist at Mount Sinai
Hospital and a professor at Mount Sinai's Icahn School of Medicine
in New York City. He called the new findings "extremely
"We're entering an era where we are identifying unique pathways for cancer, and therapies that attack the unique biology of cancer will be much more effective than we've had in the past," he said.
Fishman compared the way cancer works to a cross-country road
trip, where "there are many ways to drive from New York City to
Portland." These targeted therapies form road blocks along some of
the major routes, forcing the cancer onto little-used and less
efficient side roads.
"This is a demonstration that understanding the biology of the tumor and applying a therapy that is unique to that tumor is effective," he said.
For more about
ovarian cancer, visit the U.S. National Cancer Institute.
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