Palluzzi Eleonora, Marchetti Claudia, Cappuccio Serena, Avesani Giacomo, Macchia Gabriella, Gambacorta Maria Antonietta, Cocciolillo Fabrizio, Scambia Giovanni, Fagotti Anna
Dipartimento per la Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli-IRCCS, Rome, Italy.
Università Cattolica del Sacro Cuore, Rome, Italy.
Int J Gynecol Cancer. 2022 Sep 6;32(9):1164-1170. doi: 10.1136/ijgc-2022-003543.
The benefit of surgery and maintenance treatment with PARP inhibitors (PARPi) has been clearly demonstrated in ovarian cancer. Also, the efficacy and safety of stereotactic body radiotherapy has been shown in patients with metastatic, persistent, and recurrent disease. The aim of this study is to evaluate the management of oligometastatic progression during PARPi maintenance treatment.
This is an observational, retrospective, single-arm study conducted from June 2017 to December 2020 in patients with recurrent ovarian cancer with oligometastatic progression under PARPi maintenance treatment and receiving surgery or stereotactic body radiotherapy for such recurrence. PARPi treatment was continued until further progression of the disease. The primary objective of the study was the median prolongation of the treatment-free interval-p (without platinum) after local treatment.
A total of 186 patients with ovarian cancer were treated with PARPi at recurrence. Of these, 30 (16%) developed oligometastatic progression. The median age was 49.5 years (range 35-73). Olaparib, niraparib and rucaparib were administered to 33%, 60%, and 7% of patients, respectively. The median prolongation of the treatment-free interval-p of patients treated with surgery or stereotactic body radiotherapy was 6 and 10 months, respectively (p=0.53). The median treatment-free interval-p of patients treated with surgery or stereotactic body radiotherapy at the time of oligometastatic progression was 32 and 29 months, respectively (p=0.44). At the time of this publication, 50% of patients are still on treatment with PARPi following progression.
Patients with recurrent ovarian cancer who have oligometastic progression during PARPi maintenance may continue to benefit from PARPi if combined with local treatment.
手术及聚（腺苷酸-核糖）聚合酶抑制剂（PARPi）维持治疗在卵巢癌中的获益已得到明确证实。此外，立体定向体部放疗在转移性、持续性及复发性疾病患者中的疗效和安全性也已得到证实。本研究的目的是评估PARPi维持治疗期间寡转移进展的管理。
这是一项观察性、回顾性、单臂研究，于2017年6月至2020年12月对接受PARPi维持治疗且出现寡转移进展、并接受手术或立体定向体部放疗以治疗此类复发的复发性卵巢癌患者进行。PARPi治疗持续至疾病进一步进展。本研究的主要目的是局部治疗后无铂治疗间期-p（treatment-free interval-p）的中位数延长情况。
共有186例复发性卵巢癌患者接受了PARPi治疗。其中，30例（16%）出现寡转移进展。中位年龄为49.5岁（范围35 - 73岁）。分别有33%、60%和7%的患者接受了奥拉帕利、尼拉帕利和鲁卡帕利治疗。接受手术或立体定向体部放疗的患者无铂治疗间期-p的中位数延长分别为6个月和10个月（p = 0.53）。在寡转移进展时接受手术或立体定向体部放疗的患者无铂治疗间期-p的中位数分别为32个月和29个月（p = 0.44）。在本研究发表时，50%的患者在进展后仍在接受PARPi治疗。
在PARPi维持治疗期间出现寡转移进展的复发性卵巢癌患者，如果联合局部治疗，可能继续从PARPi治疗中获益。
