Objective: The therapeutic effect of PARP inhibitors (PARPi) monotherapy compared with platinum-based chemotherapy, and the impact to subsequent platinum-based chemotherapy after PARPi resistance were inconclusive. Design: Retrospective cohort study. Setting: Patients from seven medical centers in China. Population: BRCA1/2-mutated ovarian cancer patients with secondary platinum-sensitive relapse, without any maintenance regimen after first- and second-line platinum therapy, and the secondary platinum-free interval (PFI) was more than 6 months. Methods: Patients in study group (n=31) were treated with PARPi monotherapy until disease progression, and patients in control group (n=33) were treated with platinum-based chemotherapy without restriction. Main Outcome Measures: RECIST and GCIG standard, Kaplan-Meier plotter Results: The objective response rate (ORR: 77.4% vs. 84.0%, p=0.538) and median progression-free survival (mPFS: 8.6 vs. 11.1 months, p=0.679) were comparable. PARPi monotherapy significantly prolonged post-recurrent survival (PRS, HR=0.35, p=0.024), and was the independent factor associated with PRS (HR=0.33, p=0.038). The median time from treatment to first subsequent therapy or death (TFST) of patients with platinum-based chemotherapy after PARPi progression and patients in control group with PFI≥6months after third-line platinum-based chemotherapy was comparable (mTFST: 7.5 vs. 7.1 months, p=0.800). Further survival analysis showed that PRS of patients with PARPi monotherapy were similar to patients with PFI≥6 months after third-line platinum chemotherapy (HR=0.66, p=0.503), and superior to patients with PFI<6 months after third-line platinum chemotherapy (HR=0.15, p=0.009). Conclusions: PARPi monotherapy was equivalent to platinum-based chemotherapy for BRCA1/2-mutated ovarian cancer patients with secondary platinum-sensitive recurrence, and could improve prognosis.

Abstract Objective. To evaluate the efficacy and safety of parallel loop binding suture of the lower uterus during cesarean section in pernicious placenta previa complicated with placenta increta. Design. A retrospective study Setting. Qilu Hospital of Shandong University Population. Patients with pernicious placenta previa between November 2014 and December 2020 at the Qilu Hospital of Shandong University were eligible. Methods. The degree of placental invasion was evaluated using preoperative color Doppler ultrasonography and/or magnetic resonance imaging (MRI). Main outcome measures. Postpartum hemorrhage was evaluated as the primary outcome. Additionally, neonatal outcomes were evaluated. Results. Of the 38 patients, only 3 (7.89%) underwent hysterectomy due to massive blood loss. With parallel loop binding compression suture, the volume of blood lost ranged from 500 - 6000 (mean: 2152.63±1169.37) mL and the volume of blood transfused was between 400 - 3200 (1431.58±699.85) mL. The mean gestational age was 36 weeks and 2 days (range: 32+6 to39+6 weeks). The average operation time was 109.78 ± 33.49 min, and the average fetal childbirth time was 14.05±5.60 min. The rate of NICU admission was 36.84% (14/38). The postoperative menstrual cycle and menstrual flow both returned to normal levels. All infants at our hospital were safely discharged after treatment. Conclusion. Parallel loop binding compression suture is an effective, swift, practical, and safe method to reduce postpartum bleeding in women with pernicious placenta previa, complicated with placenta increta.