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. 2023 Jun 21:15:17588359231173181.
doi: 10.1177/17588359231173181. eCollection 2023.

Oxaliplatin prior to PARP inhibitor in BRCA-mutated ovarian cancer

Maria Ornella Nicoletto  1 , Alessandra Baldoni  2 , Francesco Cavallin  3 , Andrea Grego  4 , Cristina Falci  5 , Margherita Nardin  6 , Enzo Mammano  7 , Eleonora Lai  5 , Valter Torri  8
Affiliations

Oxaliplatin prior to PARP inhibitor in BRCA-mutated ovarian cancer

Maria Ornella Nicoletto et al. Ther Adv Med Oncol. .

Abstract

Background: The use of PARP inhibitor (PARPi) has shown a considerable benefit in progression-free survival (PFS) in relapsed, platinum-sensitive epithelial ovarian cancer (OC).

Objective: Our study aimed to investigate the impact of the last platinum-based chemotherapy treatment in response to PARPi.

Design: Retrospective cohort study.

Patients and methods: The study involved 96 consecutive, pretreated, platinum-sensitive advanced OC patients. Demographics and clinical data were retrieved from clinical records. PFS and overall survival (OS) were calculated from the start of PARPi.

Results: Germline BRCA mutation was investigated in all cases. Platinum-based chemotherapy before PARPi maintenance therapy included pegylated liposomal doxorubicin-oxaliplatin (PLD-Ox) in 46 patients (48%) and other platinum-based chemotherapy in 50 patients (52%). During a median follow-up of 22 months from the beginning of PARPi therapy, 57 patients relapsed (median PFS: 12 months) and 64 patients died (median OS: 23 months). During multivariable analysis, receiving PLD-Ox before PARPi was associated with improved PFS [hazard ratio (HR): 0.46, 95% CI: 0.26-0.82] and OS (HR: 0.48, 95% CI: 0.27-0.83). In 36 BRCA-mutated patients, PLD-Ox was associated with improved PFS (2-year PFS: 70.0% versus 25.0%, p = 0.02).

Conclusion: Receiving PLD-Ox before PARPi may improve prognosis in platinum-sensitive advanced OC patients and may provide advantages in the BRCA-mutated subgroup.

Keywords: BRCA mutated; PARP inhibitors; oxaliplatin; pegylated liposomal doxorubicin; platinum-sensitive epithelial ovarian cancer.

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Conflict of interest statement

The authors declare that there is no conflict of interest.

Figures

Figure 1.
Figure 1.
Progression-free survival (a) and overall survival (b) in OC patients who received PLD-Ox and in those who received other platinum-based chemotherapy. OC, ovarian cancer; PLD-Ox, pegylated liposomal doxorubicin-oxaliplatin.
Figure 2.
Figure 2.
Adjusted survival curves for progression-free survival (a) and overall survival (b) in OC patients who received PLD-Ox and in those who received other platinum-based chemotherapy. OC, ovarian cancer; PLD-Ox, pegylated liposomal doxorubicin-oxaliplatin.
See this image and copyright information in PMC

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