Multicenter Real-World Data of Subsequent Chemotherapy after Progression to PARP Inhibitors in a Maintenance Relapse Setting
Romeo, Margarita ![Identificador ORCID](/img/uab/orcid.ico)
(Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Gil-Martín, Marta (Hospital Universitari de Bellvitge)
Gaba, Lydia ![Identificador ORCID](/img/uab/orcid.ico)
(Hospital Clínic i Provincial de Barcelona)
Teruel, Iris ![Identificador ORCID](/img/uab/orcid.ico)
(Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Taus, Álvaro ![Identificador ORCID](/img/uab/orcid.ico)
(Hospital del Mar (Barcelona, Catalunya))
Fina, Claudia (Institut Català d'Oncologia)
Masvidal, Maria (Hospital Universitari de Reus)
Murata, Paola (Hospital Universitari Arnau de Vilanova)
Fernández Plana, Julen (Hospital Universitari MútuaTerrassa (Terrassa, Catalunya))
Martínez Bueno, Alejandro (Hospital Quirón Dexeux)
Pérez, Cristina (Xarxa Sanitària i Social Santa Tecla)
García García, Yolanda
(Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
Rodriguez, Valerie (Hospital de Tortosa Verge de la Cinta)
Cros Costa, Sara
(Hospital General de Granollers)
Parera, Marta (Hospital Universitari de Vic)
Zanui, Montserrat (Hospital de Mataró. Consorci Sanitari del Maresme)
Catot, Silvia (Xarxa Assistencial Universitària de Manresa)
Pardo, Beatriz (Hospital Universitari de Bellvitge)
Plaja, Andrea
(Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Esteve, Anna
(Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Barretina-Ginesta, Maria-Pilar
(Institut Català d'Oncologia)
Data: |
2022 |
Resum: |
Since the irruption of PARPi in the therapeutic armamentarium for ovarian cancer, concerns regarding post-progression treatment outcomes have emerged, owing to known crossed-resistance mechanisms between PARPi and platinum. In this multicentric retrospective series of ovarian cancer patients, we evaluated chemotherapy results upon progression to maintenance with PARPi in the relapsed setting. We further selected the population of platinum-sensitive patients (according to the classical definition) retreated with platinum (n = 74). In this platinum-sensitive population, overall response rate and survival outcomes of platinum rechallenge after PARPi were similar to historical series of the prePARPi era. However, within this group, analysis according to BRCA status showed that BRCA mutant patients (n = 35) presented higher rates of progression and worse survival outcomes under subsequent platinum than BRCA wild type patients (n = 39), with statistically significant differences. This is the largest real-world data series of ovarian cancer patients treated with platinum rechallenge in the post-PARPi scenario. Despite impressive progression-free survival (PFS) results from PARP inhibitors (PARPi) in ovarian cancer, concerns about their effect on post-progression treatment outcomes have recently arisen, particularly when administered in the relapsed setting. Overlapping mechanisms of resistance between PARPi and platinum have been described, and optimal therapies upon progression to PARPi are unknown. We communicate real-world data (RWD) on outcomes of subsequent chemotherapy upon progression to PARPi used as maintenance in ovarian cancer relapses, particularly focusing on platinum rechallenge, according to BRCA status. Methods: Data from high-grade serous or endometrioid ovarian cancer patients who received subsequent chemotherapy after progression to maintenance PARPi in the relapsed setting, in 16 Catalan hospitals between August 2016 and April 2021, and who were followed-up until July 2021, were included. Endpoints were overall response rate (ORR), and PFS and overall survival (OS) measured from the subsequent chemotherapy starting date. Results: 111 patients were included [46 (41. 4%) presented pathological BRCA1/2 mutations, 8 (7. 5%) in other homologous recombination-related genes]. Sixty-four patients (57. 7%) had received two prior chemotherapy lines, including the one immediately prior to PARPi. PARPi were niraparib (n = 60, 54. 1%), olaparib (n = 49, 44. 1%), and rucaparib (n = 2, 1. 8%). A total of 81 patients remained platinum-sensitive (PS population) after progression to PARPi (when progression-free interval [PFI] was. |
Drets: |
Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original. ![Creative Commons](/img/licenses/by.ico) |
Llengua: |
Anglès |
Document: |
Article ; recerca ; Versió publicada |
Matèria: |
Mechanisms of resistance ;
Ovarian cancer ;
PARP inhibitors ;
Platinum rechallenge ;
Platinum sensitivity |
Publicat a: |
Cancers, Vol. 14 (september 2022) , ISSN 2072-6694 |
DOI: 10.3390/cancers14184414
PMID: 36139574
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Registre creat el 2023-09-08, darrera modificació el 2024-07-22