Matthew Powell, MD, Washington University in St. Louis, Missouri, discusses results from the KEYLINK-001 study. Results demonstrated that first-line pembrolizumab and chemotherapy plus maintenance pembrolizumab and olaparib with or without bevacizumab improved progression-free survival (PFS) compared to chemotherapy alone among patients with advanced BRCA non-mutated epithelial ovarian cancer. 

As Dr Powell concluded, “We have a lot more investigation to come in this area, but it's really nice to see a potential new signal for use of drugs that are well known and well used and well tolerated for our patients with ovarian cancer.” 

These results were first presented at the 2025 Society of Gynecologic Oncology (SGO) Annual Meeting on Women’s Cancer in Seattle, Washington.

Transcript: 

I am Dr Matthew Powell, I'm a gynecologic oncologist from Washington University School of Medicine in St. Louis, here to talk a little bit about the KEYLINK-001 trial recently presented last Saturday at the Annual SGO Meeting in Seattle, Washington. 

The high-level results of this trial, which was a randomized, phase 3, placebo-controlled trial, for patients with ovarian cancer were quite intriguing. We were investigating new therapies to be added to standard chemotherapy for patients with ovarian cancer. As many of you know, we really have not made progress on ovarian cancer in over 20 years since the platinum-taxane combination with mostly carboplatin and [paclitaxel] became available in the mid-nineties. We've learned a lot about ovarian cancer since that time, we know we have active agents to add into this backbone of chemotherapy with the addition of PARP inhibitors, with the addition of bevacizumab, and we still don’t know how best to use those agents. We also have the new agent pembrolizumab, well, new to ovarian cancer– there's been a lot of studies looking at this, but we really were interested in how we can combine these new therapies to allow our patients to live longer, better lives. 

This was a large trial with over 1300 patients accrued, and the high-level results did show when we add these additional agents we gain progression-free survival with the addition of pembrolizumab and olaparib compared to control arm with a gain of about 8.6 months, we're recognizing a hazard ratio in the 0.6 area. When we focused in on the population of biggest interest, and again, we used a pathologic scoring system to help point us to the patients that developed the most benefit from checkpoint, and this is a CPS score ≥ 10, we were actually able to define these biomarkers which was an integral biomarker in the study, a planned integral biomarker in the study, to show these results. 

A somewhat unique finding was in our exploratory analysis. There was an intriguing observation for patients who did not receive bevacizumab, which again, this was one of the treatment options that could have been chosen by the patient and their provider, that was used about half the time, and again, the reasons for choosing bevacizumab were up to the patient and the provider but this created a unique opportunity to investigate those patients in their bevacizumab use. What we found is the patients that didn't receive bevacizumab, and they had that special scoring of CPS ≥ 10, there was really substantial improvement in their progression-free survival and their overall survival, but these patients seeming to gain more than 2 years longer overall survival and we saw an interesting flattening out of their progression-free survival curve implying that these patients seem to benefit for a long time. This certainly was intriguing. 

We have a lot more investigation to come in this area, but it's really nice to see a potential new signal for use of drugs that are well known and well used and well tolerated for our patients with ovarian cancer.

Source: 

Powell M, Cibula D, Nieuwenhuysen EV, et al. Chemotherapy with or without pembrolizumab followed by maintenance with olaparib or placebo for firstline treatment of advanced BRCA nonmutated epithelial ovarian cancer: Results from the randomized phase III ENGOT-OV43/GOG-3036/KEYLYNK-001 study. Presented at the 2025 SGO Annual Meeting on Women’s Cancer. March 14-17, 2025; Seattle, WA. Abstract 953906.