Department of Women and Child Health, Division of Gynecologic Oncology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
Dipartimento di Uro-Ginecologia, Istituto Nazionale per lo Studio e la Cura dei Tumori IRCCS Fondazione Pascale, Naples, Italy.
Gynecol Oncol. 2024 May;184:24-30. doi: 10.1016/j.ygyno.2024.01.022. Epub 2024 Jan 25.
PARP (poly adenosine diphosphate [ADP]-ribose polymerase) inhibitors are approved as maintenance therapy in platinum sensitive ovarian cancer (OC), in first line and in the recurrent setting, regardless of BRCA mutational status. Real-world data after the introduction of these agents are needed to evaluate whether the benefit observed in phase III randomized clinical trials can be translated into clinical practice. The aim of our study was to provide real-life data on efficacy and safety of niraparib administered as maintenance in platinum sensitive relapsed OC patients (PSROC).
This retrospective/prospective observational study included relapsed OC patients that received niraparib as maintenance, at the time of platinum sensitive recurrence within the Italian expanded-access program. Clinical data at the time of diagnosis and at the time of recurrence were collected and analyzed. Median progression free survival (PFS) and overall survival (OS) were calculated as the time from start of niraparib treatment to subsequent radiologically confirmed relapse and death or last contact, respectively.
Among 304 eligible patients, 260 (85%) had BRCA wild-type tumor and 36. (11.9%) were BRCA mutated. Median PFS was 9.1 months (95% CI: 6.9-11.2) and 10.3 months (95% CI: 7.0-13.5) in the BRCAwt and BRCAmut cohorts, respectively. Furthermore, median OS was 41.7 months (95% CI: 31.6-41.9) and 34.6 months (95% CI: N.E.) in the BRCAwt and BRCAmut cohorts, respectively.
Data from this large real-life dataset suggested that maintenance with niraparib in the real-life setting of platinum sensitive OC recurrence is effective and well tolerated.
PARP(聚二磷酸腺苷核糖聚合酶)抑制剂已被批准用于铂类敏感卵巢癌(OC)的维持治疗,无论 BRCA 突变状态如何,均可用于一线治疗和复发性疾病。需要真实世界数据来评估在 III 期随机临床试验中观察到的益处是否可以转化为临床实践。我们的研究旨在提供铂类敏感复发性 OC 患者(PSROC)接受尼拉帕尼维持治疗的真实数据,评估其疗效和安全性。
本回顾性/前瞻性观察性研究纳入了在意大利扩大准入计划中接受尼拉帕尼维持治疗的铂类敏感复发性 OC 患者。收集并分析了诊断时和复发时的临床数据。无进展生存期(PFS)和总生存期(OS)的中位数分别计算为从尼拉帕尼治疗开始至随后影像学证实的复发和死亡或最后一次随访的时间。
在 304 名符合条件的患者中,260 名(85%)为 BRCA 野生型肿瘤,36 名(11.9%)为 BRCA 突变型。BRCAwt 队列和 BRCAmut 队列的中位 PFS 分别为 9.1 个月(95%CI:6.9-11.2)和 10.3 个月(95%CI:7.0-13.5)。此外,BRCAwt 队列和 BRCAmut 队列的中位 OS 分别为 41.7 个月(95%CI:31.6-41.9)和 34.6 个月(95%CI:未达到)。
来自这一大规模真实世界数据集的数据表明,在铂类敏感 OC 复发的真实环境中,尼拉帕尼维持治疗是有效且耐受良好的。