Efficacy of poly (ADP-ribose) polymerase inhibitors monotherapy and the impact to subsequent platinum-based chemotherapy in breast cancer susceptibility genes1/2-mutated ovarian cancer patients with secondary platinum-sensitive relapse.

Abstract

BACKGROUND:

The therapeutic effect of poly (ADP-ribose) polymerase inhibitors (PARPi) monotherapy compared with platinum-based chemotherapy, and the impact to subsequent platinum-based chemotherapy after PARPi resistance were inconclusive in breast cancer susceptibility genes (BRCA)1/2-mutated ovarian cancer patients with secondary platinum-sensitive relapse.

METHODS:

BRCA1/2-mutated patients with secondary platinum-sensitive relapse included in this study did not receive any maintenance regimen after first- and second-line platinum-based chemotherapy, and the secondary platinum-free interval (PFI) was more than 6 months. Patients in study group were treated with PARPi monotherapy until disease progression, and patients in control group were treated with platinum-based chemotherapy without restriction. Progression-free survival (PFS) was defined as the time from third-line therapy to disease progression or death, PFS2 was defined as the time from platinum-based chemotherapy after PARPi resistance to next subsequent therapy or death. Post-recurrence survival (PRS) refers to the survival time after secondary platinum-sensitive relapse.

RESULTS:

A total of 119 patients were retrospectively analyzed, including 71 (59.7%) in study group and 48 (40.3%) in control group. The objective response rate (ORR: 77.5% vs. 80.0%, p=0.766) and PFS (median: 11.2 vs. 11.0 months, p=0.962) were comparable. The benefit of subsequent platinum-based chemotherapy after PARPi resistance was more pronounced in patients with PARPi treatment for more than 12 months (median PFS2: 8.6 vs. 4.3 months, p=0.040). PARPi monotherapy had no adverse effect on PRS compared with platinum-based chemotherapy (median PRS:41.2 vs. 42.8 months, p=0.323). Compared to patients in control group who had never received PARPi, PARPi monotherapy (median PRS: 41.2 vs. 33.7 months, p=0.019) and post-line treatment with PARPi in the control group (median PRS: 48.1 vs. 33.7 months, p=0.002) could prolong PRS for patients with secondary platinum-sensitive relapse.

CONCLUSIONS:

PARPi monotherapy was similar to platinum-based chemotherapy for BRCA1/2-mutated ovarian cancer patients with secondary platinum-sensitive recurrence, and could improve prognosis.

• Authors: Yana Ma, Jiale Liu, Ning Li, Hualei Bu, Yongwen Huang, Chengjuan Jin, Hao Wen, Shuai Feng, Hui Zhang, Xiaorong Yang, Beihua Kong, Lingying Wu, Kun Song
• Journal: Journal of ovarian research (J Ovarian Res) Vol. 16 Issue 1 Pg. 209 (Oct 28 2023) ISSN: 1757-2215 [Electronic] England
• PMID: 37891662 (Publication Type: Journal Article)
• Copyright: © 2023. The Author(s).

Chemical References

• Poly(ADP-ribose) Polymerase Inhibitors
• BRCA1 protein, human
• BRCA1 Protein
• Ribose
• Platinum
• BRCA2 protein, human
• BRCA2 Protein

Topics

• Humans
• Female
• Poly(ADP-ribose) Polymerase Inhibitors (pharmacology, therapeutic use)
• BRCA1 Protein (genetics)
• Ribose (therapeutic use)
• Platinum (pharmacology, therapeutic use)
• Retrospective Studies
• Breast Neoplasms (drug therapy, genetics)
• BRCA2 Protein (genetics)
• Ovarian Neoplasms (drug therapy, genetics)
• Carcinoma, Ovarian Epithelial (drug therapy)
• Recurrence
• Disease Progression
• Neoplasm Recurrence, Local (drug therapy, genetics)