Abstract
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.
Key words: PARPi monotherapy, platinum-sensitive recurrence,
BRCA1/2 mutation, post-recurrent survival
Tweetable
abstract
PARPi monotherapy was equivalent to platinum-based chemotherapy for
BRCA1/2-mutated patients, and could improve prognosis.