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Abstract
Introduction/Background PARP inhibitors resistance is a problematic step in epithelial ovarian cancer (EOC) management and sequencing strategies should be carried out to overcome it. In this context, to lack of data, our study evaluated the role of a non-platinum doublet pegylated liposomal doxorubicin(PLD)/trabectedin in ovarian cancer platinum-sensitive patients who experienced disease progression under PARP inhibitors maintenance.
Methodology This is a case-control study including patients with recurrent EOC treated between 2016–2021 who progressed under PARP inhibitors maintenance. Data of patients, treated with PLD/trabectedin were matched 1:1 with a series of patients who received platinum-based treatment. The study outcomes were: overall clinical benefit (including complete, partial and stable response), progression-free survival(PFS) and overall survival(OS). The safety of both treatments was also evaluated.
Progression free survival
Overall survival
Results 26 patients in both groups were analyzed. Clinical benefit was achieved in 15 (57%) patients in study group and 17 (65%) in control one (p = 0.38). Patients receiving PLD/trabectedin had 5 months of PFS, compared with 5 months of patients treated with platinum-based treatment (p = 0.62). OS of the entire population was 84 months (95% CI = 68–99), with no significant difference between the experimental and control group (75 vs. 87 months, p = 0.30). No clinically relevant differences were found in terms of safety.
Conclusion PLD/trabectedin might be as effective as a platinum-based treatment in patients experiencing disease progression while on PARP inhibitors maintenance, with acceptable toxicity profile. Therefore, it could be a good therapeutic option in this setting, sparing platinum compounds for subsequent relapse.