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奥拉帕利维持单药治疗铂敏感复发性卵巢癌、输卵管癌和原发性腹膜癌日本患者的疗效和安全性。

Efficacy and safety of olaparib maintenance monotherapy for Japanese patients with platinum-sensitive relapsed ovarian, fallopian tube, and primary peritoneal cancer.

机构信息

Department of Obstetrics and Gynecology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.

Department of Obstetrics and Gynecology, Inagi Municipal Hospital, Tokyo, Japan.

出版信息

Int J Clin Oncol. 2022 Oct;27(10):1644-1650. doi: 10.1007/s10147-022-02212-x. Epub 2022 Jul 15.

Abstract

BACKGROUND

Olaparib maintenance therapy for platinum-sensitive relapsed ovarian cancer has been approved in Japan since April 2018. Here, we report the experience administering this therapy in our hospital, with the aim of evaluating efficacy and safety in the Japanese population.

METHODS

The study included 52 patients with platinum-sensitive relapsed ovarian, fallopian tube, and primary peritoneal cancer. All patients started olaparib at a dose of 300 mg twice daily. Information about treatment efficacy and adverse effects was collected retrospectively from medical records.

RESULTS

Median age was 58 years old (range: 33-80), and 82.7% of the patients were diagnosed with high-grade serous carcinoma. Sixteen patients (30.8%) possessed the BRCA1/2 pathogenic variant (15 germline and 1 tissue), 3 (5.8%) possessed variants of unknown significance (2 germline and 1 tissue), 16 (30.8%) possessed wild type, and 17 (32.7%) were not analyzed. Median progression-free survival was 15.3 months (95% CI 9.0-21.6). Patients with BRCA1/2 pathogenic variants showed significantly longer PFS than patients with wild-type BRCA1/2 (p = 0.007). Disease progression caused 34 cases to discontinue olaparib. Eighteen (34.6%) individuals exhibited ≥ grade 3 anemia, although they recovered in response to appropriate management. One patient discontinued olaparib because of prolonged renal dysfunction. Another patient presented with grade 3 fatigue, but recovered after 2 weeks of interruption and continued olaparib treatment.

CONCLUSION

Olaparib maintenance therapy for platinum-sensitive recurrent ovarian cancer in the Japanese population is sufficiently safe and no less effective than reports from previous studies.

摘要

背景

奥拉帕利维持治疗铂敏感复发性卵巢癌自 2018 年 4 月在日本获得批准。在此,我们报告了在我院应用该疗法的经验,旨在评估其在日本人群中的疗效和安全性。

方法

该研究纳入了 52 例铂敏感复发性卵巢癌、输卵管癌和原发性腹膜癌患者。所有患者均起始奥拉帕利 300mg,每日两次。从病历中回顾性收集治疗疗效和不良反应的信息。

结果

中位年龄为 58 岁(范围:33-80 岁),82.7%的患者诊断为高级别浆液性癌。16 例(30.8%)患者携带 BRCA1/2 致病性变异(15 例胚系和 1 例组织),3 例(5.8%)患者携带意义不明的变异(2 例胚系和 1 例组织),16 例(30.8%)患者携带野生型,17 例(32.7%)患者未进行分析。中位无进展生存期为 15.3 个月(95%CI 9.0-21.6)。携带 BRCA1/2 致病性变异的患者无进展生存期显著长于携带野生型 BRCA1/2 的患者(p=0.007)。疾病进展导致 34 例患者停止奥拉帕利治疗。18 例(34.6%)患者发生≥3 级贫血,但经适当治疗后恢复。1 例患者因肾功能持续异常而停止使用奥拉帕利。另 1 例患者出现 3 级疲劳,但停药 2 周后恢复并继续使用奥拉帕利治疗。

结论

奥拉帕利维持治疗铂敏感复发性卵巢癌在日本人群中是安全的,疗效不劣于既往研究报道。

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