Mali Barbi, Medical Oncologist at Northwell Health, shared a post on X:
“My ASCO26 Ovarian Cancer recap PART 2.
One approval incoming. One negative trial. And an ADC pipeline that just got very crowded.
Platinum-resistant ovarian cancer (PROC) ROSELLA taxane subgroup answered the most common clinical hesitation: OS benefit holds even if your patient got taxane last. HR 0.67 in patients who received taxane most recently. HR 0.60 with taxane-free interval 6 months or less. No biomarker selection required.
FDA PDUFA July 11. Relacorilant is coming to your clinic. Know it now.
The mechanism matters here. Relacorilant blocks the glucocorticoid receptor. GR activation drives taxane resistance. The biology explains the subgroup consistency.
The setback MIROVA missed. Mirvetuximab plus carboplatin did not improve outcomes in platinum-sensitive FRα-high disease. Mirvetuximab stays in PROC. Indication expansion did not hold.
The pipeline Three new ADC programs in PROC presented this week alone.
TUB040: NaPi2b target, exatecan payload, phase 1 dose escalation (NAPISTAR 1-01) TemabA: cMet ADC, AbbVie, activity in unselected AND cMet-selected PROC PuxiSam: B7-H4 ADC, responses in ovarian cohort alongside EC data
FRα. NaPi2b. cMet. B7-H4. Four targets. Multiple payloads. One disease.
Sequencing is going to be the next hard problem in PROC. We do not have that answer yet.
My clinical take for tomorrow in clinic:
Platinum-resistant patient who already got taxane and you have been hesitating on relacorilant: stop hesitating. The subgroup data were built for exactly that patient.
Know your FRα status on every PROC patient at diagnosis. Know your cMet and B7-H4 status by the time they hit second or third line. Trials are open now and the targets are actionable.
If your patient has progressed on mirvetuximab in PROC, there is no approved next step. Get them on a trial. TUB-040, TemabA, and PuxiSam are all enrolling.”
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