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. 2024 Mar 5;17(1):55.
doi: 10.1186/s13048-024-01381-9.

A real-world study of treatment patterns following disease progression in epithelial ovarian cancer patients undergoing poly-ADP-ribose polymerase inhibitor maintenance therapy

Nan Zhang  1 , Hong Zheng  2 , Yunong Gao  1 , Tong Shu  1 , Hongguo Wang  1 , Yan Cai  1
Affiliations

A real-world study of treatment patterns following disease progression in epithelial ovarian cancer patients undergoing poly-ADP-ribose polymerase inhibitor maintenance therapy

Nan Zhang et al. J Ovarian Res. .

Abstract

Background: The efficacy of subsequent therapy after poly-ADP-ribose polymerase (PARP) inhibitor maintenance treatment has raised concerns. Retrospective studies show worse outcomes for platinum-based chemotherapy after progression of PARP inhibitor-maintenance therapy, especially in BRCA-mutant patients. We aimed to describe subsequent therapy in ovarian cancer patients after PARP inhibitor-maintenance therapy and evaluate their response to treatment. We focused on chemotherapy for patients with a progression-free interval (PFI) of ≥ 6 months after prior platinum treatment, based on BRCA status.

Methods: We analyzed real-world data from Peking University Cancer Hospital, subsequent therapy after progression to PARP inhibitor-maintenance therapy for epithelial ovarian cancer between January 2016 and December 2022. Clinicopathological characteristics and treatment outcomes were extracted from medical records. The last follow-up was in May 2023.

Results: A total of 102 patients were included, of which 29 (28.4%) had a germline BRCA1/2 mutation and 73 (71.6%) exhibited BRCA1/2 wild-type mutations. The PARP inhibitors used were Olaparib (n = 62, 60.8%), Niraparib (n = 35, 34.3%), and others (n = 5, 4.9%). The overall response rate (ORR) was 41.2%, and the median time to second progression (mTTSP) was 8.1 months (95%CI 5.8-10.2). Of 91 platinum-sensitive patients (PFI ≥ 6 months) after progression to PARP inhibitor-maintenance therapy, 65 patients subsequently received platinum regimens. Among them, 30 had received one line of chemotherapy before PARP inhibitor-maintenance therapy. Analysis of these 30 patients by BRCA status showed an ORR of 16.7% versus 33.3% and mTTSP of 7.1 (95% CI 4.9-9.1) versus 6.2 months (95% CI 3.7-8.3, P = 0.550), for BRCA-mutant and wild-type patients, respectively. For the remaining 35 patients who had received two or more lines of chemotherapy before PARP inhibitor-maintenance therapy, ORR was 57.1% versus 42.9%, and mTTSP was 18.0 (95% CI 5.0-31.0) versus 8.0 months (95% CI 4.9-11.1, P = 0.199), for BRCA-mutant and wild-type patients, respectively.

Conclusion: No differences in survival outcomes were observed among patients with different BRCA statuses. Furthermore, for patients who had undergone two or more lines of chemotherapy before PARP inhibitor maintenance therapy, no negative effects of PARP inhibitors on subsequent treatment were found, regardless of BRCA status.

Keywords: BRCA; Epithelial ovarian cancer; Maintenance therapy; PARP; Subsequent therapy.

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Conflict of interest statement

The authors have no relevant financial or non-financial interests to disclose

Figures

Fig. 1
Fig. 1
The inclusion/exclusion process and outline of the treatment patterns post PARPi maintenance therapy
Fig. 2
Fig. 2
Kaplan-Meier estimates of TTSP in PS patients who received one line of subsequent chemotherapy before PARPi maintenance therapy based on BRCA status
Fig. 3
Fig. 3
Kaplan-Meier estimates of TTSP in PS patients who received two or more lines of subsequent chemotherapy before PARPi maintenance therapy based on BRCA status
See this image and copyright information in PMC

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References

    1. Moore K, Colombo N, Scambia G, Kim BG, Oaknin A, Friedlander M, Engl, et al. Maintenance Olaparib in patients with newly diagnosed Advanced Ovarian Cancer. N. J Med. 2018;379(26):2495–505. doi: 10.1056/NEJMoa1810858. - DOI - PubMed
    1. Pujade-Lauraine E, Ledermann JA, Selle F, Gebski V, Penson RT, Oza AM, et al. Olaparib tablets as maintenance therapy in patients with platinum-sensitive, relapsed ovarian cancer and a BRCA1/2 mutation (SOLO2/ENGOT-Ov21): a double-blind, randomised, placebo-controlled, phase 3 trial. Lancet Oncol. 2017;18(9):1274–84. doi: 10.1016/s1470-2045(17)30469-2. - DOI - PubMed
    1. Mirza MR, Monk BJ, Herrstedt J, Oza AM, Mahner S, Redondo A, Engl, et al. Niraparib Maintenance Therapy in Platinum-Sensitive, recurrent ovarian Cancer. N. J Med. 2016;375(22):2154–64. doi: 10.1056/NEJMoa1611310. - DOI - PubMed
    1. González-Martín A, Pothuri B, Vergote I, DePont Christensen R, Graybill W, Mirza MR, Engl, et al. Niraparib in patients with newly diagnosed Advanced Ovarian Cancer. N. J Med. 2019;381(25):2391–402. doi: 10.1056/NEJMoa1910962. - DOI - PubMed
    1. Coleman RL, Oza AM, Lorusso D, Aghajanian C, Oaknin A, Dean A, et al. Rucaparib maintenance treatment for recurrent ovarian carcinoma after response to platinum therapy (ARIEL3): a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet. 2017;390(10106):1949–61. doi: 10.1016/s0140-6736(17)32440-6. - DOI - PMC - PubMed

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