PARP inhibitor maintenance treatment for newly diagnosed ovarian cancer patients: a real-world study from China

Jinghong Chen; Mengpei Zhang; Kemin Li; Yuanqiong Duan; Jing Zeng; Qingli Li; Danqing Wang; Liang Song; Qintong Li; Rutie Yin

doi:10.3389/fonc.2024.1336616

PARP inhibitor maintenance treatment for newly diagnosed ovarian cancer patients: a real-world study from China

Front Oncol. 2024 Feb 2:14:1336616. doi: 10.3389/fonc.2024.1336616. eCollection 2024.

Authors

Jinghong Chen^{1

2}, Mengpei Zhang^{1

2}, Kemin Li^{1

2}, Yuanqiong Duan^{1

2}, Jing Zeng^{1

2}, Qingli Li^{1

2}, Danqing Wang^{1

2}, Liang Song^{1

2}, Qintong Li^#^{1

2}, Rutie Yin^#^{1

2}

Affiliations

¹ Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China.
² Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China.

^# Contributed equally.

Abstract

Purpose: This study evaluated the efficacy and safety in a real-world population of epithelial ovarian cancer (EOC) treated with poly (ADP-ribose) polymerase inhibitor (PARPi) as first-line maintenance therapy in the largest gynecologic oncology center in Western China.

Methods: This study included patients newly diagnosed EOC who received PARPi as first-line maintenance therapy in West China Second University Hospital from August 1, 2018 to September 31, 2022. The primary endpoints were progression-free survival (PFS) and safety evaluated by Common Terminology Criteria for Adverse Events Version 5.0(CTCAE 5.0). The secondary endpoints were overall survival (OS) and prognostic factors influencing the PFS of patients in real world.

Results: Among the eligible 164 patients, 104 patients received olaparib and 60 patients received niraparib. 100 patients (61.0%) had mutations in breast cancer susceptibility gene (BRCA). 87 patients (53.0%) received primary debulking surgery (PDS) while 77 patients (47.0%) received interval debulking surgery (IDS). 94 patients (94/164, 57.3%) achieved R0 and 39 patients (23.8%) achieved R1 after PDS/IDS. 112 (68.3%) achieved complete response (CR) after first-line chemotherapy, while 49 (29.9%) achieved partial response (PR). The median follow-up time was 17.0 months (95% CI 15.6-18.4), and the median PFS has not been reached yet. Multivariate analysis demonstrated that BRCA mutations and CR/PR after platinum-based chemotherapy were independent factors associated with prolonged PFS. Hematologic toxicity was the most common grade≥3 AE. There were no incidence of myelodysplastic syndromes/acute myelogenous leukemia (MDS/AML).

Conclusion: Focusing on PARPi as first-line maintenance therapy for patients with EOC, this study represented the largest single-center real-world study in China to date. Two independent factors were identified to prolong the PFS of patients: BRCA mutated type and CR/PR after primary treatment, which should be further confirmed with long-term follow-up and large sample sizes.

Keywords: adverse events; ovarian cancer; poly (ADP-ribose) polymerase inhibitors; progression-free survival; real-world study.

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This research was funded by the Key Project of Sichuan Provincial Department of Science and Technology (19ZDYF), the Horizontal Science and Technology Project of Sichuan University (23H1223), and the National Natural Science Foundation of China (No.31971141, No.32271348).