Nicoletto Maria Ornella, Baldoni Alessandra, Cavallin Francesco, Grego Andrea, Falci Cristina, Nardin Margherita, Mammano Enzo, Lai Eleonora, Torri Valter
Medical Oncology 2, Istituto Oncologico Veneto IRCCS, via Gattamelata 64, Padova, 35121, Italy.
Department of Medical Oncology, AULSS 3 Serenissima, Mirano Hospital, Mirano, (VE), Italy.
Ther Adv Med Oncol. 2023 Jun 21;15:17588359231173181. doi: 10.1177/17588359231173181. eCollection 2023.
The use of PARP inhibitor (PARPi) has shown a considerable benefit in progression-free survival (PFS) in relapsed, platinum-sensitive epithelial ovarian cancer (OC).
Our study aimed to investigate the impact of the last platinum-based chemotherapy treatment in response to PARPi.
Retrospective cohort study.
The study involved 96 consecutive, pretreated, platinum-sensitive advanced OC patients. Demographics and clinical data were retrieved from clinical records. PFS and overall survival (OS) were calculated from the start of PARPi.
Germline BRCA mutation was investigated in all cases. Platinum-based chemotherapy before PARPi maintenance therapy included pegylated liposomal doxorubicin-oxaliplatin (PLD-Ox) in 46 patients (48%) and other platinum-based chemotherapy in 50 patients (52%). During a median follow-up of 22 months from the beginning of PARPi therapy, 57 patients relapsed (median PFS: 12 months) and 64 patients died (median OS: 23 months). During multivariable analysis, receiving PLD-Ox before PARPi was associated with improved PFS [hazard ratio (HR): 0.46, 95% CI: 0.26-0.82] and OS (HR: 0.48, 95% CI: 0.27-0.83). In 36 BRCA-mutated patients, PLD-Ox was associated with improved PFS (2-year PFS: 70.0% 25.0%, = 0.02).
Receiving PLD-Ox before PARPi may improve prognosis in platinum-sensitive advanced OC patients and may provide advantages in the BRCA-mutated subgroup.
聚（ADP-核糖）聚合酶抑制剂（PARPi）的使用已显示出在复发的铂敏感上皮性卵巢癌（OC）的无进展生存期（PFS）方面有显著益处。
我们的研究旨在调查最后一次铂类化疗对PARPi反应的影响。
回顾性队列研究。
该研究纳入了96例连续的、经过预处理的铂敏感晚期OC患者。人口统计学和临床数据从临床记录中获取。PFS和总生存期（OS）从PARPi开始时计算。
所有病例均检测了胚系BRCA突变。PARPi维持治疗前的铂类化疗包括46例患者（48%）接受聚乙二醇脂质体阿霉素-奥沙利铂（PLD-Ox），50例患者（52%）接受其他铂类化疗。从PARPi治疗开始的中位随访22个月期间，57例患者复发（中位PFS：12个月），64例患者死亡（中位OS：23个月）。在多变量分析中，PARPi之前接受PLD-Ox与改善的PFS相关[风险比（HR）：0.46，95%置信区间（CI）：0.26-0.82]和OS（HR：0.48，95%CI：0.27-0.83）。在36例BRCA突变患者中，PLD-Ox与改善的PFS相关（2年PFS：70.0%对25.0%，P=0.02）。
PARPi之前接受PLD-Ox可能改善铂敏感晚期OC患者的预后，并可能在BRCA突变亚组中提供优势。
