Real-world experience of olaparib as maintenance therapy in BRCA-mutated recurrent ovarian cancer

• Published in: Archives of gynecology and obstetrics Vol. 304; no. 4; pp. 1055 - 1063
• Main Authors: Cho, Angela, Park, Jeong-Yeol, Lee, Shin-Wha, Kim, Dae-Yeon, Suh, Dae-Shik, Kim, Jong-Hyeok, Kim, Yong-Man, Kim, Young-Tak
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.10.2021; Springer Nature B.V
• Subjects: Cancer therapies; Chemotherapy; Endocrinology; Gynecologic Oncology; Gynecology; Human Genetics; Medical prognosis; Medicine; Medicine & Public Health; Obstetrics/Perinatology/Midwifery; Ovarian cancer; Olaparib; Maintenance therapy; BRCA mutation; Ovarian cancer
• ISSN: 0932-0067; 1432-0711
• DOI: 10.1007/s00404-021-06013-x

Purpose The primary objective of our study was to investigate the effectiveness and safety of olaparib maintenance therapy in patients with BRCA-mutated recurrent ovarian cancer in daily practice. The secondary objective of this study was to identify prognostic factors associated with prolonged progression-free survival (PFS) in such patients. Methods We conducted a retrospective analysis of 40 patients who received olaparib maintenance treatment. Data on clinicopathological factors, oncological outcomes, and adverse events were obtained from medical records and analyzed. Results All patients had high-grade serous recurrent ovarian cancer with BRCA mutation and achieved complete or partial response to the most recent platinum-based chemotherapy. After a median follow-up of 14.3 months, the median PFS was 23.7 months (95% confidence interval, 14.1–33.4); however, the median overall survival was not reached. In the log-rank test, the PFS was significantly longer for patients with most recent platinum-free interval (PFI) ≥ 12 months, complete response to the last platinum-based chemotherapy, and less than three lines of previous chemotherapy ( p  = 0.005, p  = 0.016, and p  = 0.023, respectively). Most hematologic and non-hematologic adverse events were of grade 1 or 2, and the common adverse events were mostly related to myelosuppression. Conclusion Olaparib maintenance treatment in BRCA-mutated recurrent ovarian cancer is effective and safe in clinical practice. Most recent PFI, response to the last platinum-based chemotherapy, and the number of previous chemotherapy lines were associated with PFS in patients with BRCA-mutated recurrent ovarian cancer.