Real-World Treatment Patterns of Maintenance Therapy in Platinum-Sensitive Recurrent Ovarian Cancer

2021 Year in Review - Ovarian Cancer —March 21, 2022

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Ovarian Cancer

Findings of a retrospective study indicate that patients with platinum-sensitive recurrent ovarian cancer were increasingly being administered maintenance therapy after second-line or third-line platinum-based chemotherapy regardless of biomarker status.

A retrospective study evaluated real-world treatment patterns of maintenance therapy with poly (ADP-ribose) polymerase (PARP) inhibitors or bevacizumab in patients with ovarian cancer who had received previous platinum-based chemotherapy. The results were published in the October 2021 issue of Gynecologic Oncology.

This study used an electronic health record–derived deidentified (US nationwide Flatiron Health) database to select patients diagnosed with ovarian cancer who had received ≥2 lines of platinum-based chemotherapy. Patients who completed platinum-based chemotherapy on or after March 1, 2017, had ≥2 months of active surveillance or received maintenance therapy with a PARP inhibitor or bevacizumab were analyzed. Data on biomarker status were also obtained.

A total of 2292 eligible patients with ovarian cancer were identified. Of these, 222 patients completed platinum-based chemotherapy and had ≥2 months of active surveillance or received maintenance therapy with a PARP inhibitor or bevacizumab. Biomarker analysis showed that 46 (20%) patients had BRCA mutations (BRCAm), 132 (59%) had a wild-type BRCA (BRCAwt) gene, and 47 (21%) were of unknown status. Although the majority of patients with BRCAm received a PARP inhibitor (63%), approximately one-third of the eligible patients did not (17% received bevacizumab, and 20% underwent active surveillance). Among the patients with BRCAwt, 40% received a PARP inhibitor, 23% received bevacizumab, and 36% underwent active surveillance. Younger patients and those with BRCAm received maintenance therapy more frequently. The use of PARP inhibitors increased on average by 1.3% every 3 months (P = .02) with no significant change in the use of bevacizumab.

Based on these results, the researchers concluded that maintenance therapy with a PARP inhibitor or bevacizumab was increasingly being administered after second-line or third-line platinum-based chemotherapy, regardless of biomarker status. These results also indicate shifting treatment patterns in a real-world population of patients with recurrent ovarian cancer.

Source: Moss HA, Perhanidis JA, Havrilesky LJ, Secord AA. Real-world treatment patterns of maintenance therapy in platinum-sensitive recurrent ovarian cancer. Gynecol Oncol. 2021;163:50-56.

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Last modified: November 15, 2022

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