Dr. Richardson on the Rationale for the UPNEXT Trial in Ovarian Cancer

Debra L. Richardson, MD, FACS, FACOG, associate professor, Section of Gynecologic Oncology, Oklahoma TSET Phase I Program, Stephenson Cancer Center, The University of Oklahoma (OU) College of Medicine, OU Health, discusses the rationale for the ongoing phase 3 UPNEXT trial in platinum-sensitive ovarian cancer.

Maintenance therapy options are being moved into the frontline setting for patients with ovarian cancer, which means that some patients who are eligible for maintenance treatment will have been previously treated with bevacizumab (Avastin) or a PARP inhibitor, either sequentially or in combination, Richardson says. However, no standard of care exists for these patients upon relapse, Richardson explains. Moreover, some patients are ineligible for current maintenance options because of comorbidities, Richardson adds.

As such, the UPNEXT trial is opening an opportunity to assess the antibody-drug conjugate upifitamab rilsodotin vs placebo as maintenance in patients with platinum-sensitive ovarian cancer. The trial will enroll patients with stable disease, as well as those with complete responses (CRs) or partial responses (PRs) to frontline therapy, Richardson continues. Currently, PARP inhibitors are not approved as maintenance therapy in this setting, so only patients with a prior CRs or PRs would be eligible for a PARP inhibitor, Richardson says. Overall, if a patient receives a PARP inhibitor in the up-front setting, it's unclear whether they could be rechallenges with another PARP inhibitor, Richardson concludes.