According to results from a study published in the journal Gynecologic Oncology, the use of maintenance therapy is expanding for patients with platinum-sensitive, recurrent ovarian cancer, regardless of biomarker status. Researchers conducted a retrospective study of patients in a U.S. database, including 2,292 patients with recurrent ovarian cancer who had received second- or third-line platinum-based chemotherapy.
In the study, 222 patients had completed chemotherapy and had at least 2 months of active surveillance (n = 78) or received maintenance therapy with a poly[ADP-ribose] polymerase (PARP) inhibitor or bevacizumab (n = 147). At baseline, the patients' average age was 66.1 years; 69% were Caucasian, and 6% were of Hispanic or Latina ethnicity. Breast cancer gene (BRCA) mutations were present in 20% of patients, 59% had wild-type BRCA, and 21% of patients had unknown BRCA status.
The majority of patients with BRCA mutations (63%) received a PARP inhibitor, 17% received bevacizumab, and 20% underwent active surveillance; the PARP inhibitor prescribed 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 prescribed 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 prescribed most often was niraparib (28%), followed by olaparib (13%) and rucaparib (2%).
It was found that younger patients were more likely to receive maintenance therapy compared with patients older than age 75 years. Among patients who underwent active surveillance, 32% were older than age 75 years.
The authors determined that the use of PARP inhibitors increased by 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 shift in the use of bevacizumab (P = .22). The authors noted, "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 authors concluded that, in their real-world population study, maintenance therapy is becoming progressively more widespread following second- or third-line platinum-based chemotherapy regardless of biomarker status. They also noted that these results provide greater understanding into shifting treatment patterns for patients with recurrent ovarian cancer.
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