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尼拉帕利在日本作为维持疗法的研究:一项使用日本医保数据库的回顾性观察性研究

Niraparib as maintenance therapy in Japan: a retrospective observational study using a Japanese claims database.

作者信息

Motohashi Takashi, Shimada Muneaki, Tokunaga Hideki, Kuwahara Yuki, Kuwabara Hiroyo, Kato Ai, Tabata Tsutomu

机构信息

Department of Obstetrics and Gynecology, Tokyo Women's Medical University, Tokyo, Japan.

Department of Gynecology, Tohoku University Hospital, Sendai, Japan.

出版信息

J Gynecol Oncol. 2025 Mar;36(2):e19. doi: 10.3802/jgo.2025.36.e19. Epub 2024 Jul 4.

Abstract

OBJECTIVE

Epithelial ovarian cancer (EOC) is the leading cause of female mortality in gynecologic malignancies, with a rising incidence in Japan. This study aimed to validate the treatment patterns and safety of niraparib as maintenance therapy for EOC following initial chemotherapy in clinical practice in Japan.

METHODS

Leveraging claims data between April 2008 and December 2022, this descriptive study comprised EOC-diagnosed patients receiving initial platinum-based chemotherapy, debulking surgery, and niraparib as maintenance therapy. Patient characteristics, prescription status, transfusion details, and laboratory data were assessed and reported as summary statistics and frequencies.

RESULTS

Among 291 patients, the median age was 64.0 years and 94.5% received a 200-mg daily dose of niraparib. At week 12, 78.7% (229/291) continued niraparib treatment, 21.3% (62/291) discontinued, and 52.2% (152/291) required treatment interruptions. Of the 62 patients who discontinued treatment, 27 patients initiated subsequent EOC treatment within 12 weeks following niraparib discontinuation. Blood transfusions were needed in 10.3% (30/291), and of 55 patients with available laboratory data, 61.8% (34/55) had decreased platelet count <100,000/µL, 25.5% (14/55) had decreased hemoglobin level <8 g/dL, and 22.7% (5/22) had decreased neutrophil count <1,000/µL, meeting the criteria for treatment interruption. Among those with thrombocytopenia, 88.2% (30/34) were able to either resume or continue treatment.

CONCLUSION

Niraparib demonstrated favorable tolerability in Japanese patients with advanced EOC, with effective management of thrombocytopenia through dose adjustments and supportive care, supporting its viability as post-chemotherapy maintenance therapy.

摘要

目的

上皮性卵巢癌(EOC)是妇科恶性肿瘤中导致女性死亡的主要原因,在日本其发病率呈上升趋势。本研究旨在验证在日本临床实践中,尼拉帕利作为EOC初始化疗后维持治疗的治疗模式及安全性。

方法

利用2008年4月至2022年12月期间的索赔数据,这项描述性研究纳入了接受初始铂类化疗、肿瘤减灭术以及尼拉帕利作为维持治疗的EOC确诊患者。对患者特征、处方状态、输血详情及实验室数据进行评估,并作为汇总统计数据和频率进行报告。

结果

在291例患者中,中位年龄为64.0岁,94.5%的患者接受每日200毫克的尼拉帕利剂量。在第12周时,78.7%(229/291)继续接受尼拉帕利治疗,21.3%(62/291)停药,52.2%(152/291)需要中断治疗。在62例停药患者中,27例在尼拉帕利停药后12周内开始了后续的EOC治疗。10.3%(30/291)的患者需要输血,在55例有可用实验室数据的患者中,61.8%(34/55)的血小板计数下降至<100,000/µL,25.5%(14/55)的血红蛋白水平下降至<8 g/dL,22.7%(5/22)的中性粒细胞计数下降至<1,000/µL,符合中断治疗的标准。在血小板减少的患者中,88.2%(30/34)能够恢复或继续治疗。

结论

尼拉帕利在日本晚期EOC患者中显示出良好的耐受性,通过剂量调整和支持性护理对血小板减少进行了有效管理,支持其作为化疗后维持治疗的可行性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0b59/11964971/8ca7068a3d6d/jgo-36-e19-g001.jpg

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