Use of PARP Inhibitor Maintenance on the Rise in Platinum-Sensitive, Recurrent Ovarian Cancer

Female patient
PARP inhibitor use increased regardless of BRCA mutation status.

The use of maintenance therapy is becoming more common for patients with platinum-sensitive, recurrent ovarian cancer, regardless of biomarker status, according to a real-world study published in Gynecologic Oncology.

Researchers conducted a retrospective study of patients in a US database. The study included 2292 patients with recurrent ovarian cancer who had received second- or third-line platinum-based chemotherapy.

There were 222 patients who had completed chemotherapy and had at least 2 months of active surveillance (n=78) or received maintenance therapy with a PARP inhibitor or bevacizumab (n=147).

At baseline, the patients’ mean age was 66.1 years; 69% were White, and 6% were of Hispanic or Latino ethnicity. BRCA mutations were present in 20% of patients, 59% had wild-type BRCA, and 21% patients had unknown BRCA status.

Most patients with BRCA mutations (63%) received a PARP inhibitor, 17% received bevacizumab, and 20% underwent active surveillance. The PARP inhibitor given most often was olaparib (26%), followed by niraparib (24%) and rucaparib (13%).

Among patients with wild-type BRCA, 40% received a PARP inhibitor, 36% underwent active surveillance, and 23% received bevacizumab. The PARP inhibitor given most often was niraparib (21%), followed by olaparib (10%) and rucaparib (9%).

Among patients with unknown BRCA mutation status, 45% underwent active surveillance, 43% received a PARP inhibitor, and 13% received bevacizumab. The PARP inhibitor given most often was niraparib (28%), followed by olaparib (13%) and rucaparib (2%).

Younger patients were more likely to receive maintenance therapy than patients who were older than 75 years of age. Among patients who underwent active surveillance, 32% were older than 75 years.

The use of PARP inhibitors increased an average of 1.3% every 3 months (P =.02), and the use of active surveillance decreased by an average of 1.8% (P <.01). There was no significant change in the use of bevacizumab (P =.22).

“Additional follow-up is needed to understand the impact of different maintenance strategies in real-world settings on survival outcomes and quality of life and assess how the integration of PARP [inhibitors] in the frontline setting will impact treatment patterns in the recurrent setting,” the study authors wrote.

Disclosures: This research was supported by GlaxoSmithKline. Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.

Reference

Moss HA, Perhanidis JA, Havrilesky LJ, et al. Real-world treatment patterns of maintenance therapy in platinum-sensitive recurrent ovarian cancer. Gynecol Oncol. Published July 20, 2021. doi:10.1016/j.ygyno.2021.07.026