Kokabu Tetsuya, Tarumi Yosuke, Aoki Kota, Okamura Ayaka, Aoyama Kohei, Kataoka Hisashi, Yoriki Kaori, Mori Taisuke
Department of Obstetrics and Gynecology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan.
Cancers (Basel). 2024 Jul 25;16(15):2651. doi: 10.3390/cancers16152651.
The clinical outcomes in patients with ovarian cancer have been significantly improved by Poly(adenosine diphosphate-ribose) polymerase inhibitors (PARP-is). However, the best therapeutic strategy for recurrence during PARP-i maintenance therapy remains unknown. Herein, we elucidated the efficacy of platinum-based chemotherapy after PARP-i treatment in recurrent ovarian cancer. Eligible patients had experienced relapses during PARP-i maintenance therapy lasting at least 6 months and had received subsequent platinum-based chemotherapy at our institution between January 2019 and March 2024. Progression-free survival (PFS), overall survival (OS), and risk factors for PFS were evaluated. Sixty-six patients were assessed for eligibility and eighteen were enrolled. The median follow-up period was 14.5 months. The PFS and OS of all patients were 6.5 and 17.6 months, respectively. The evaluation of the risk factors for PFS revealed that age, pathological type, duration of PARP-i maintenance therapy, prior lines of chemotherapy, and PARP-i dose reduction were not significant prognostic markers. However, bevacizumab use in subsequent therapies significantly extended the PFS. The median PFS was 3.1 months in the chemotherapy-alone group and 8.9 months in the chemotherapy with bevacizumab group (log-rank = 0.022). Platinum-based chemotherapy with bevacizumab in subsequent therapies would provide substantial benefits in the PFS of patients with recurrent ovarian cancer.
聚（腺苷二磷酸核糖）聚合酶抑制剂（PARP抑制剂）显著改善了卵巢癌患者的临床预后。然而，PARP抑制剂维持治疗期间复发的最佳治疗策略仍不明确。在此，我们阐明了PARP抑制剂治疗后铂类化疗对复发性卵巢癌的疗效。符合条件的患者在PARP抑制剂维持治疗至少6个月期间出现复发，并于2019年1月至2024年3月在我们机构接受了后续铂类化疗。评估了无进展生存期（PFS）、总生存期（OS）以及PFS的危险因素。对66例患者进行了资格评估，18例患者入组。中位随访期为14.5个月。所有患者的PFS和OS分别为6.5个月和17.6个月。对PFS危险因素的评估显示，年龄、病理类型、PARP抑制剂维持治疗时间、既往化疗线数以及PARP抑制剂剂量减少均不是显著的预后标志物。然而，后续治疗中使用贝伐单抗显著延长了PFS。单纯化疗组的中位PFS为3.1个月，化疗联合贝伐单抗组为8.9个月（对数秩检验P = 0.022）。后续治疗中铂类化疗联合贝伐单抗将为复发性卵巢癌患者的PFS带来显著益处。
