Department of Obstetrics and Gynecology, Kyorin University Faculty of Medicine, Tokyo, Japan.
J Obstet Gynaecol Res. 2023 Dec;49(12):2883-2888. doi: 10.1111/jog.15798. Epub 2023 Sep 21.
Ovarian cancer is a gynecological malignancy with a poor prognosis. For platinum-sensitive relapsed ovarian cancer, maintenance therapy with poly-ADP ribose polymerase (PARP) inhibitors after chemotherapy is considered; however, olaparib treatment does not always lead to sufficient progression-free survival (PFS). This study aimed to identify factors that predict the efficacy of maintenance therapy using olaparib in platinum-sensitive relapsed ovarian cancer.
Twenty-seven patients with platinum-sensitive relapsed ovarian cancer, who received initial treatment and showed complete or partial response to prior chemotherapy at our hospital, were included. The primary outcome was the time from the end of previous platinum-based chemotherapy to disease progression (PFS). The Kaplan-Meier method was used to generate time-to-event curves for PFS; multivariate analysis was performed using the Cox proportional hazards regression model.
The median PFS was 12 months (95% confidence interval [CI]: 8.3-15.8). Before olaparib administration, the median PFS was 12 months in the <4.1 neutrophil-to-lymphocyte ratio group and 4 months in the ≥4.1 group, with PFS being significantly better in the <4.1 group (log-rank: p = 0.023). When comparing serum cancer antigen 125 (CA125) levels, the median PFS was 13 months in the <18 U/mL group and 6 months in the >18 U/mL group (log-rank: p = 0.022). Multivariate Cox regression analysis revealed that CA125 was the factor affecting PFS (hazard ratio: 4.85; 95% CI: 1.53-15.38).
Serum CA125 levels at olaparib initiation in patients with platinum-sensitive relapsed ovarian cancer may predict PFS as an effect of maintenance therapy using olaparib to treat recurrent disease.
卵巢癌是一种预后不良的妇科恶性肿瘤。对于铂类敏感复发的卵巢癌，在化疗后使用聚 ADP 核糖聚合酶（PARP）抑制剂进行维持治疗被认为是有效的；然而，奥拉帕利治疗并不总能带来足够的无进展生存期（PFS）。本研究旨在确定影响铂类敏感复发卵巢癌患者接受奥拉帕利维持治疗疗效的因素。
纳入 27 例在我院接受初始治疗且对既往化疗有完全或部分缓解的铂类敏感复发卵巢癌患者。主要终点为上次铂类化疗结束至疾病进展（PFS）的时间。采用 Kaplan-Meier 法生成 PFS 的时间-事件曲线；采用 Cox 比例风险回归模型进行多变量分析。
中位 PFS 为 12 个月（95%置信区间[CI]：8.3-15.8）。在接受奥拉帕利治疗之前，中性粒细胞与淋巴细胞比值<4.1 组的中位 PFS 为 12 个月，比值≥4.1 组为 4 个月，<4.1 组的 PFS 显著更长（对数秩检验：p=0.023）。比较血清癌抗原 125（CA125）水平，CA125<18 U/mL 组的中位 PFS 为 13 个月，CA125>18 U/mL 组为 6 个月（对数秩检验：p=0.022）。多变量 Cox 回归分析显示，CA125 是影响 PFS 的因素（风险比：4.85；95%CI：1.53-15.38）。
铂类敏感复发卵巢癌患者在接受奥拉帕利治疗时的血清 CA125 水平可能预测 PFS，这是奥拉帕利治疗复发性疾病维持治疗的效果。
