After Misdiagnosis, Patient Sees Promise With Immunotherapy Combination for Advanced Ovarian Cancer

Marcia Goglia was given a laxative and sent home from the Emergency Room after doctors told her that the extreme stomach pain she was feeling was likely constipation. But knowing that something was indeed wrong, Goglia followed-up with a gastroenterologist. It turns out, she was right. Goglia had been misdiagnosed and the pain she was experiencing was ovarian cancer. The news was not something she expected to hear. Even less so that it was already stage 3 and beginning to spread.

Goglia, 64, of Middletown, Connecticut, had no family history or genetic predisposition to ovarian cancer. She attributes the disease to just “plain old bad luck.”

Ovarian cancer, in its early stages, often has no symptoms or they may not be obvious to the disease. Women many experience symptoms such as bloating, frequent urination, loss of appetite, abdominal pain, fatigue, heartburn or constipation. When caught early and treated, the five-year survival rate is greater than 90 percent. However, in advanced stages or recurrence of the disease the odds are more fatal. The five-year survival rate at stage 3 is 39 percent.

Goglia underwent the standard surgery, followed by chemotherapy at The Carole and Ray Neag Comprehensive Cancer Center at UConn Health in Farmington, Connecticut. When the chemotherapy stopped working, her doctors attempted different chemotherapy combinations. They tried this unsuccessfully for more than a year. That’s when Goglia’s gynecologic-oncologist at UConn Health mentioned a clinical trial.

This clinical trial was evaluating the combination of two immunotherapies, Keytruda (pembrolizumab) and the experimental agent, epacadostat (epac). This drug is meant for a number of advanced cancers, including ovarian cancer.

A few months into the trial, Goglia’s tumors had all shrunk and the tumor on her liver was gone. Not to mention, the cancer markers in her blood were low.

Goglia calls the trial “a miracle” and says if it weren’t for the team at UConn Health, she “might not be here right now.” There is still a long way to go for Goglia, but the trial and its therapy have given her hope.

The clinical trial, ECHO-202, is showing positive results of Keytruda plus epacadostat: the combination is well tolerated and has promising clinical activity. A phase 3 study (NCT02752074) of patients with advanced melanoma is currently enrolling patients.

Goglia recommends that patients with advanced cancers should consider clinical trials. “If your traditional cancer treatment isn’t working don’t be afraid to pursue your clinical trial options,” she says.

“By enrolling in a clinical trial, a person may be helping their own health,” says Jeffrey Wasser, M.D., the principal clinical investigator at Neag Cancer Center. “But they are also helping others by contributing to the advancement of potential and promising cures going forward.”

Goglia continues to receive good news. Her latest images show that her ovarian cancer continues to shrink, showing that this immunotherapy combination has early promise.