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EPV201/#44 Real-world data analysis of second-line poly (ADP-RIBOSE) polymerase inhibitor maintenance therapy in patients with advanced ovarian cancer
  1. R Reid1,
  2. Y Xie2,
  3. J Shi2 and
  4. K Wallace3
  1. 1US Oncology, Virginia Cancer Specialists, Medical Oncology, Fairfax, USA
  2. 2Ontada, Real World Research, The Woodlands, USA
  3. 3Clovis Oncology, Inc., Health Economics and Outcomes Research, Boulder, USA


Objectives Poly(ADP-ribose) polymerase inhibitors (PARPis) have been recommended since 2017 as second-line (2L) maintenance treatment by the NCCN for ovarian cancer (OC) patients with or without BRCA1 or BRCA2 (BRCA) alterations. Here, we assessed PARPi use from real-world data.

Methods From the iKnowMed electronic health record database of the US Oncology Network (>470 sites), adult females were included if they were diagnosed with advanced OC, received a 2L platinum-containing regimen for advanced OC, and had ≥2 visits between 1 January 2016 and 1 July 2020. Patients were followed until 31 October 2020, last patient record, or death, whichever occurred earliest. A 24-month landmark survival analysis was performed.

Results Out of 11,494 patients diagnosed with advanced OC, 1051 met the inclusion criteria; 513/1051 (49%) subsequently received any maintenance therapy (table 1). The proportion of patients receiving 2L PARPi maintenance increased from 17% in 2018 to 34% in 2019 but decreased to 22% in 2020 (figure 1). Among BRCA+patients, 33% (46/140) received 2L PARPi maintenance, while documented BRCApatients received PARPi maintenance at a significantly lower rate (23%; 155/622; P=0.0192). Survival at 24 months was significantly higher with PARPi maintenance vs active surveillance: 61.2% (95% CI, 52.4%–68.8%) vs 53.0% (95% CI, 47.1%–58.7%; log-rank P=0.0045) (figure 2).

Abstract EPV201/#44 Table 1
Abstract EPV201/#44 Figure 1

Propotion of patients receiving 2L PARPi maintenance (active surveillance)

Abstract EPV201/#44 Figure 2

Overall survival

Conclusions Our data suggest a significant proportion of eligible patients are not receiving 2L maintenance therapy despite treatment guideline recommendations and apparent survival benefits associated with its use.

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