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#201 Real world evidence (RWE) on the efficacy of chemotherapy after progression during or following PARPi exposure in ovarian cancer. a multicentre, international study
  1. Jean-Sebastien Frenel1,
  2. Catherine Guerin-Charbonnel1,
  3. Alexandre Xu-Vuillard2,
  4. Sur Cheeseman3,
  5. Paul Kubelac4,
  6. Morgan Zenatri5,
  7. Geoffrey Hall6,
  8. Patriciu Patriciu4,
  9. Brunhilde Hanvic7,
  10. Hayley Fenton8,
  11. Ana-Maria-Lacrima Sturz-Lazar9,
  12. Paule Augereau10,
  13. Isabelle Ray-Coquard11,
  14. Alexandra Leary12 and
  15. François Bocquet5
  1. 1Institut de Cancerologie de L’ouest, Nantes, France
  2. 2Institut Gustave Roussy, Villejuif, France
  3. 3Leeds hospital, Leeds, UK
  4. 4Kluj, Kluj, Romania
  5. 5Institut de Cancerologie de L’Ouest, Saint-Herblain, France
  6. 6Leeds, Leeds, UK
  7. 7Centre Leon Berard, Lyon, France
  8. 8IQVIA, London, UK
  9. 9City Hospital, Timisoara, Romania
  10. 10Institut de Cancerologie de L’Ouest, Angers, France
  11. 11Centre Léon Bérard, Lyon, France
  12. 12Gustave Roussy, Villejuif, France


Introduction/Background A significant proportion of OC patients eventually progress during or following PARPi exposure. Progression under PARPi may undermine sensitivity to chemotherapy.

Methodology We retrospectively identified patients treated with a PARPi as maintenance in the 4 participating centers and who received subsequent CT. We evaluated progression-free survival (PFS) calculated from the start of the subsequent CT to the next progression/death.

Results 291 patients were identified (2003–2021). PARPi exposure was as maintenance in adjuvant (n=41) or relapsed setting (n=250) with a median number of previous lines of chemotherapy of 1 (range: 1.0–7.0). Progression under PARPi exposure was predominant (n=253/291; 87%). BRCA mutation was identified in 129 pts and negative/unknown in 162 pts. Median duration of PARPi exposure was 6.5 months (range: 0.2–54.3). Subsequent treatment included platinum-based CT (PBC) for 182 (62.5%) pts and non-platinum-based CT (nPBC) for 109 (37.5%) pts. With a median follow-up of 25.3 months (95% CI [23.0; 31.7]), median PFS was 6.7 m (95% CI [5.7; 7.6]) and 3.5 m (95% CI [2.8; 4.6]) with PBC and nPBC respectively. In BRCA mutated pts, median PFS was 6.7 [5.2; 8.3] and 2.7 [2.4; 4.3] with subsequent PBC (n=99) and nPBC (n=30) based CT respectively. Platinum free interval (PFI) under PARPi was associated with numerically longer PFS with subsequent CT: PFI ≤ 6m (PFS =3.0m [2.7;4.1]) ; PFI ]6 ;12] (PFS=6.5m [4.7 ;7.6]) and PFI> 12 m (PFS= 6.9m [5.9 ;8.0]). Subsequent treatment for adjuvant PARPi exposure included PBC for 35 (85.4%) pts. With a median follow-up of 16.8m (95% CI [9.3;-]), median PFS was 6.8m (95% CI [5.1;10.3]) with PBC for these patients.

Conclusion This is the largest series of RWE on the efficacy of chemotherapy after progression under PARPi maintenance. Outcomes appear poor when pts progress under the pressure of PARPi whether received in 1st or subsequent lines.

Disclosures See online

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