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281 Real-world-data on platinum outcomes after parp inhibitors progression in high grade serous ovarian cancer patients
  1. Andrea Plaja Salarich1,
  2. Iris Teruel García1,
  3. Beatriz Pardo Burdalo2,
  4. Marta Gil-Martin2,
  5. Josep Maria Piulats Rodriguez2,
  6. Claudia Fina Planas3,
  7. María Pilar Barretina Ginesta3,
  8. Andrea Gonzalez Valencia4,
  9. Anna Esteve Gomez4 and
  10. Margarita Romeo Marin1
  1. 1Catalan Institute of Oncology (Ico)-Badalona, Germans Trias I Pujol University Hospital (Hugtip); Badalona-Applied Research Group in Oncology (B-Argo); Medical Oncology Department
  2. 2Catalan Institute of Oncology (Ico)-Idibell, L’hospitalet; Medical Oncology Department
  3. 3Catalan Institute of Oncology (Ico)-Girona, Girona Biomedical Research Institute (Idibgi); Medical Oncology Department
  4. 4Catalan Institute of Oncology (Ico)-Badalona, Germans Trias I Pujol University Hospital (Hugtip); Badalona-Applied Research Group in Oncology (B-Argo); Statistics Department


Introduction/Background PARP inhibitors (PARPi) maintenance after Platinum (Pt) based chemotherapy (CT) significantly improves progression-free survival (PARPi-PFS) and PFS after subsequent (ssq) CT (PARPi-PFS2) in relapsed high grade serous ovarian cancer (HGSOC). Data regarding ssq CT is scarce, and PARPi/Pt crossed mechanisms of resistance may impact on outcome of ssq Pt. We provide Real-world-data on this issue.

Methodology We included HGSOC p treated with ssq CT after progression to maintenance PARPi until 15th Jul 2020 in 3hospitals. Endpoints were related to this ssq CT: objective response rate (ORR), median(m) progression-free survival (PFS) and overall survival (OS). Multivariate Cox and logistic regression models were adjusted by BRCA status and Pt-free interval (PFI) (6–12 months(mo) vs ≥12 mo). Adjusted hazard ratios (aHR) and odds ratios (aOR) of the risk of progression/death and ORR, respectively, were reported with 95% confidence intervals (CI).

Results 56p were identified (32p BRCAmut; 1p BRIP1mut). 4p (7.1%) received PARPi after 1st line CT, 26 (46.4%) after 2nd line and 26 (46.4%) after ≥3rd line. 34p (60.7%) received olaparib and 22 (39.3%) niraparib. m-PARPi-PFS in the recurrent setting was 7.5 mo (longer in BRCAmut: 10.1 vs 5.5 mo, p 0.03). m-PARPi-PFS2 was 15.8 mo (longer in BRCAmut: 20.9 vs 15.4 mo, p 0.07).

Endpoints regarding ssq CT are shown in table1. ORR to ssq Pt was 33.3% and progression disease without any response 28.6%. ORR in p who received ssq Pt-free CT, ssq Pt with PFI 6–12 mo, and ssq Pt with PFI≥12 mo were 33.3%, 23.8% and 42.8%, respectively. Five complete responses occurred among BRCAmut p that had received PARPi in the recurrent setting. mPFS and mOS were significantly longer in the PFI≥12 subgroup vs the others (figure1).

Focusing in p receiving ssq Pt, when adjusting by BRCA status: aOR of ORR in p with PFI≥12 vs 6–12 mo was 0.56 (95% CI: 0.13 – 2.30), aHR of mPFS between these two subgroups was 0.61 (95% CI: 0.30–1.20; p 0.16), and aHR of mOS was 0.20 (95% CI: 0.7–0.61, p 0.005). Results did not change when excluding the 4p who received PARPi as 1st line.

Abstract 281 Figure 1

Ssq CT-OS (left) and ssq CT-PFS (right)

Abstract 281 Table 1

Endpoints regarding ssq CT

Conclusion A trend towards higher benefit from ssq Pt after PARPi was observed in the PFI≥12 subgroup. Benefit from ssq Pt after PARPi in the PFI 6–12 subgroup was similar to benefit from CT in the non-Pt subgroup. The role of ssq Pt after PARPi in the PFI 6–12 subgroup warrants further research.

Disclosures Andrea Plaja: travel grant for attending scientific meeting (Roche, Angelini).

Marta Gil-Marin: speaking (Roche, Astra Zeneca, Pharmamar) and travel grants (Roche, Pharmamar, MSD).

Beatriz Pardo: speaking (Roche, Astra Zeneca, MSD) and travel grants (Roche, MSD, GSK).

Josep Maria Piulats: advisory board (Astra Zeneca, MSD, Clovis, BeiGene) and travel grants (Astra Zeneca, MSD, BeiGene).

María Pilar Barretina: advisory board (Roche, Astra Zeneca, GSK, Clovis Oncology), speaking (Roche, Astra Zeneca, GSK, Clovis Oncology, Pharmamar) and travel grants (Roche, GSK, Astra Zenaca, Pharmamar).

Clàudia Fina: travel grants (Roche, MSD, Pfizer, Bristol-Myers)

Margarita Romeo: advisory boards (AZ, TESARO) and travel grants (Pfizer).

Iris Teruel, Anna Esteve and Andrea Gonzalez have nothing to disclosure.

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