This phase II pilot study (AdORN) evaluated the safety and feasibility of adding atezolizumab to neoadjuvant carboplatin/paclitaxel in 18 patients with newly diagnosed high-grade stage III/IV epithelial ovarian cancer (EOC) planned for interval cytoreductive surgery (ICS), with translational immune biomarker assessment.
Atezolizumab did not delay ICS in any patient due to immunotherapy-related toxicity (only 1 ICS delay occurred from thromboembolism). Optimal cytoreduction was achieved in 13/15 patients (86%); 9/15 (60%) had partial response and 6/15 (40%) had stable disease. Responders showed elevated post-treatment CXCL10, TNFα, and IL-10 versus stable disease patients.
- Early termination after enrolling only 18 of 40 planned patients (triggered by negative IMagyn050 trial results), severely limiting statistical power. - No comparator arm; single-arm design prevents efficacy conclusions. - Predominantly white (78%), older (median age 69) cohort limits generalizability.
Adding atezolizumab to NACT appears feasible without meaningfully delaying surgery, but the trial was underpowered and no efficacy signal can be confirmed. Clinicians should not adopt this regimen outside a trial setting given the negative context of the larger IMagyn050 study.
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