Chase Dana M, Shukla Soham, Moore Julia, Boyle Tirza Areli Calderón, Lim Jonathan, Perhanidis Jessica, Hurteau Jean A, Schilder Jeanne M
David Geffen School of Medicine at UCLA, 855 Tiverton Dr, Los Angeles, CA, 90024, USA.
GSK, Upper Providence, PA, USA.
Oncol Ther. 2024 Sep;12(3):599-607. doi: 10.1007/s40487-024-00294-3. Epub 2024 Aug 4.
Niraparib first-line maintenance (1LM) therapy has demonstrated clinical benefit for patients with ovarian cancer (OC) in clinical trial and real-world settings, but data on factors associated with real-world patient outcomes remain limited. This analysis identified patient characteristics associated with time to next treatment (TTNT), a proxy for real-world progression-free survival, in patients with OC treated with 1LM niraparib monotherapy.
This retrospective observational study used a USA nationwide electronic health record-derived deidentified database and included adult patients diagnosed with OC who initiated 1LM niraparib monotherapy after first-line platinum-based chemotherapy. Patients were followed until the earliest occurrence of last clinical activity, death, or end of study period. TTNT was measured from 1LM niraparib initiation to the start of second-line treatment or death. Cox proportional hazards models assessed univariable and multivariable associations between baseline characteristics and TTNT.
Of 7872 patients diagnosed with OC, 526 met the eligibility criteria and were included in this analysis. Median (IQR) duration of follow-up was 14.1 (7.4-23.6) months. In univariable analyses, age, BRCA/homologous recombination deficiency (HRD) status, socioeconomic status, stage at initial diagnosis, cytoreductive surgery type, and residual disease status were significantly associated with observed TTNT and were introduced into the multivariable model with other clinically relevant variables. In the multivariable analysis, BRCA/HRD status, cytoreductive surgery type, and residual disease status were significantly associated with observed TTNT after covariate adjustment. Conversely, age, Eastern Cooperative Oncology Group performance status, disease stage, niraparib starting dose status, and first-line bevacizumab use were not associated with observed TTNT.
This real-world, retrospective, observational analysis offers valuable insights on prognostic factors associated with TTNT in patients with OC treated with 1LM niraparib monotherapy after first-line platinum-based chemotherapy. Future studies are needed to examine how additional patient characteristics associated with clinical outcomes may guide treatment decisions and improve outcomes.
尼拉帕利一线维持(1LM)治疗在临床试验和真实世界环境中已证明对卵巢癌(OC)患者具有临床益处,但关于与真实世界患者预后相关因素的数据仍然有限。本分析确定了接受1LM尼拉帕利单药治疗的OC患者中与下次治疗时间(TTNT)相关的患者特征,TTNT是真实世界无进展生存期的一个替代指标。
这项回顾性观察性研究使用了一个源自美国全国电子健康记录的去识别数据库,纳入了在一线铂类化疗后开始1LM尼拉帕利单药治疗的成年OC患者。对患者进行随访,直至最早出现末次临床活动、死亡或研究期结束。TTNT从1LM尼拉帕利开始使用至二线治疗开始或死亡进行测量。Cox比例风险模型评估基线特征与TTNT之间的单变量和多变量关联。
在7872例诊断为OC的患者中,526例符合纳入标准并纳入本分析。中位(IQR)随访时间为14.1(7.4 - 23.6)个月。在单变量分析中,年龄、BRCA/同源重组缺陷(HRD)状态、社会经济地位、初始诊断分期、减瘤手术类型和残留疾病状态与观察到的TTNT显著相关,并与其他临床相关变量一起纳入多变量模型。在多变量分析中,经过协变量调整后,BRCA/HRD状态、减瘤手术类型和残留疾病状态与观察到的TTNT显著相关。相反,年龄、东部肿瘤协作组体能状态、疾病分期、尼拉帕利起始剂量状态和一线使用贝伐单抗与观察到的TTNT无关。
这项真实世界、回顾性、观察性分析为接受一线铂类化疗后使用1LM尼拉帕利单药治疗的OC患者中与TTNT相关的预后因素提供了有价值的见解。未来需要进行研究,以探讨与临床结局相关的其他患者特征如何指导治疗决策并改善结局。