Stephenson Cancer Center, University of Oklahoma, Oklahoma City, Oklahoma, USA
Nordic Society of Gynaecological Oncology Clinical Trial Unit, Copenhagen, Denmark.
Int J Gynecol Cancer. 2024 Nov 4;34(11):1753-1760. doi: 10.1136/ijgc-2024-005405.
Real-world data evaluating how approvals of novel treatment regimens for ovarian cancer have impacted the treatment paradigm, including first-line maintenance, are lacking. This analysis aimed to describe treatment patterns for advanced epithelial ovarian cancer in Europe and the USA in the first-line maintenance setting. Patient characteristics, biomarker testing rates, and drivers of treatment choice were also evaluated.
A retrospective chart review study of electronic medical records in Europe and the USA was conducted for patients diagnosed with epithelial ovarian cancer (June 1, 2017-May 31, 2020), in line with Healthcare Market Research guidelines. Eligible physicians extracted data from electronic medical records by completing standardized patient record forms, including questions on patient involvement in treatment decisions. Patients with advanced (stage III/IV) disease were stratified by country and diagnosis date to provide information on treatment patterns.
Patient record forms for 7072 patients with epithelial ovarian cancer were completed by 416 physicians; 5386 patients had stage III/IV ovarian cancer. Over time, the percentage of patients who were tested for mutations or homologous recombination deficiency increased. Patient preference was documented as a reason for treatment selection in approximately one-sixth of cases in the first-line adjuvant and first-line maintenance settings. The use of first-line maintenance poly(ADP-ribose) polymerase inhibitor monotherapy increased over time, while the use of vascular endothelial growth factor inhibitor monotherapy decreased.
This real-world study showed that treatment patterns for advanced epithelial ovarian cancer varied by country. Rates of physician-reported patient involvement in treatment decisions in the first-line adjuvant and maintenance treatment settings for ovarian cancer were low, highlighting an unmet need for initiatives to improve patient involvement in shared decision-making regarding maintenance therapy selection.
缺乏评估新型卵巢癌治疗方案获批如何影响治疗模式（包括一线维持治疗）的真实世界数据。本分析旨在描述欧洲和美国一线维持治疗环境中晚期上皮性卵巢癌的治疗模式。还评估了患者特征、生物标志物检测率以及治疗选择的驱动因素。
根据医疗保健市场研究指南，对欧洲和美国的电子病历进行了回顾性图表审查研究，纳入了 2017 年 6 月 1 日至 2020 年 5 月 31 日期间诊断为上皮性卵巢癌的患者。符合条件的医生通过填写标准化患者记录表格从电子病历中提取数据，其中包括患者参与治疗决策的问题。根据国家和诊断日期对晚期（III/IV 期）疾病患者进行分层，以提供治疗模式信息。
416 名医生完成了 7072 名上皮性卵巢癌患者的病历记录表格，其中 5386 名患者患有 III/IV 期卵巢癌。随着时间的推移，检测 突变或同源重组缺陷的患者比例有所增加。大约有六分之一的一线辅助和一线维持治疗病例中，患者的偏好被记录为治疗选择的原因。一线维持多聚（ADP-核糖）聚合酶抑制剂单药治疗的使用随着时间的推移而增加，而血管内皮生长因子抑制剂单药治疗的使用则减少。
这项真实世界的研究表明，晚期上皮性卵巢癌的治疗模式因国家而异。一线辅助和维持治疗卵巢癌中报告的医生患者参与治疗决策的比例较低，这突显了需要采取措施来提高患者对维持治疗选择的共同决策的参与度。
