California Pacific/Palo Alto Medical Foundation/Sutter Health, Palo Alto.
GSK, Collegeville, PA.
Am J Clin Oncol. 2023 Jul 1;46(7):314-322. doi: 10.1097/COC.0000000000001010. Epub 2023 Apr 28.
This study used real-world population data to assess the trends of first-line (1L) poly(ADP-ribose) polymerase inhibitor (PARPi) maintenance treatment uptake and outcomes in patients with primary advanced ovarian cancer (AOC).
Patients diagnosed with AOC between January 1, 2017, and June 30, 2021, who completed 1L chemotherapy were selected from a real-world database. Descriptive analyses were performed to evaluate patient demographics, clinicopathological characteristics, and 1L treatment patterns. Time to next treatment or death was used as a proxy for real-world progression-free survival (rwPFS). Kaplan-Meier methods and Cox models were used for statistical analyses.
Of 705 patients who completed 1L chemotherapy, 166 received PARPi monotherapy and 539 underwent active surveillance (AS). Median follow-up was 10.9 months for PARPi monotherapy and 20.6 months for AS. PARPi monotherapy use increased from 6% in 2017 to 53% in 2021. Overall, patients receiving PARPi monotherapy had longer rwPFS than those who underwent AS (not reached vs 9.53 mo) respectively. rwPFS was also longer in patients who received PARPi monotherapy compared with AS in patients with BRCA- mutated disease (not reached vs 11.4 mo), BRCA- wild-type disease (13.5 vs 9.1 mo), homologous recombination-deficient tumors (not reached vs 10.2 mo), and homologous recombination-proficient or unknown status tumors (13.5 vs 9.3 mo).
Our real-world analysis suggested that 47% of patients with primary AOC did not receive PARPi maintenance in the year 2021. PARPi use was associated with significantly improved outcomes compared with AS.
本研究利用真实世界人群数据评估原发性晚期卵巢癌（AOC）患者一线（1L）聚（ADP-核糖）聚合酶抑制剂（PARPi）维持治疗接受率和结局的趋势。
从真实世界数据库中选择 2017 年 1 月 1 日至 2021 年 6 月 30 日期间诊断为 AOC 且完成 1L 化疗的患者。开展描述性分析以评估患者的人口统计学、临床病理特征和 1L 治疗模式。下一次治疗或死亡时间用于替代真实世界无进展生存期（rwPFS）。采用 Kaplan-Meier 方法和 Cox 模型进行统计学分析。
在完成 1L 化疗的 705 例患者中，166 例接受 PARPi 单药治疗，539 例接受主动监测（AS）。PARPi 单药治疗的中位随访时间为 10.9 个月，AS 为 20.6 个月。PARPi 单药治疗的使用率从 2017 年的 6%上升到 2021 年的 53%。总体而言，接受 PARPi 单药治疗的患者 rwPFS 长于接受 AS 的患者（未达到 vs 9.53 个月）。在 BRCA 突变疾病（未达到 vs 11.4 个月）、BRCA 野生型疾病（13.5 个月 vs 9.1 个月）、同源重组缺陷肿瘤（未达到 vs 10.2 个月）和同源重组功能正常或未知状态肿瘤（13.5 个月 vs 9.3 个月）中，接受 PARPi 单药治疗的患者 rwPFS 也长于接受 AS 的患者。
本真实世界分析表明，2021 年 47%的原发性 AOC 患者未接受 PARPi 维持治疗。与 AS 相比，PARPi 的应用与显著改善的结局相关。
