Poly ADP-ribose polymerase inhibitors (PARPIs) have received US and European regulatory approvals for the treatment of BRCA-associated ovarian cancer. The approval of PARPIs in rapid succession has resulted in a paradigm shift in the management of recurrent ovarian cancer.
2,116 ovarian cancer patients (pts) in advanced/metastatic (adv/met) lines of therapy from Jan 2016 to Oct 2018 in EU5 (France, Germany, Spain, Italy, UK) were identified within Oncology Dynamics, an IQVIA oncology-syndicated cross-sectional survey collecting anonymized patient-level data. Maintenance therapy was also investigated in 534 pts.
Platinum-based regimens for the treatment of adv/met ovarian cancer pts decreased from 56% in 2017 to 50% by Oct 2018. In contrast, the use of PARPIs increased from 9% to 14%. A reduction in the administration of PARPIs was noted in all platinum-based regimens (▾15% and ▾13% in 2nd and 3rd+ lines adv/met) and in non-platinum chemotherapy (▾8% and ▾9% in 2nd and 3rd+ lines adv/met). However, in platinum-sensitive ovarian cancer pts, there has been an increase of PARPIs in 2nd and 3rd+ lines (given to 27% and 29% pts, respectively). The use in the 1st line adv/met setting has also increased by 3% (administered to 8% of pts). Prior to PARPIs, most of the pts were treated with platinum-based regimens (97%). As maintenance treatment, PARPIs have been most used in 2nd (26%) and 3rd+ line (22%) in platinum-sensitive adv/met ovarian cancer. 93% of adv/met ovarian cancer pts treated with PARPIs had an ECOG status of ≤ 1 and most suffered no comorbidities (50%). Peritoneum was the most common metastatic site (63%), followed by lymph nodes (38%). Nearly all pts had been tested for BRCA1/2 and 79% of them presented mutations. Progression was the most common reason for stopping treatment with PARPIs (72%); and anaemia, nausea, vomiting, neutropenia, and rash were the most common side effects on historic patient records.
PARPIs have certainly shown a meaningful impact on progression-free survival in pts with platinum-sensitive recurrent ovarian cancer, without any deleterious impact on the quality of life. The use of PARPIs is rising in the platinum-sensitive ovarian cancer population in clinical practice.
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A. Martinez de Pinillos: Full / Part-time employment: IQVIA C. Anger: Full / Part-time employment: IQVIA L. Mendoza: Full / Part-time employment: IQVIA