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EP280/#231  Response to subsequent platinum-based chemotherapy post PARP inhibitor in recurrent epithelial ovarian cancer
  1. Genevieve Macaulay Vacheresse1 and
  2. Tien Le2
  1. 1University of Ottawa, Gynecologic Oncology, Ottawa, Canada
  2. 2The Ottawa Hospital, Gynecologic Oncology, Ottawa, Canada


Introduction Maintenance therapy with PARP inhibitors (PARPi) can increase progression free survival (PFS) in recurrent or metastatic platinum-sensitive epithelial ovarian cancer (EOC), though some evidence suggests a decreased response to subsequent platinum-based chemotherapy. This study assessed real-world response rates to platinum-based chemotherapy for recurrent high grade EOC following treatment with a PARPi.

Methods Single center retrospective cohort study of patients prescribed a PARPi as maintenance therapy for recurrent or metastatic EOC, including 54 patients on niraparib and 36 patients on olaparib. Median duration of follow-up after PARPi initiation was 16.3 months.

Results Of the 91 patients included in the analysis, 54 (59.3%) experienced disease progression after PARPi therapy, including 10 (11.0%) who progressed within 6 months of their penultimate therapy. Of the 44 patients with disease progression more than 6 months following penultimate therapy, 32 (72.7%) were rechallenged with platinum-based chemotherapy. Of these, 14 (43.8%) further progressed within 6 months of their platinum rechallenge. Median PFS following platinum rechallenge was 4.4 months. Incidence of platinum resistance was 26.4% in the overall population and 44.4% in those with disease progression after initiation of PARPi therapy.

Conclusion/Implications Disease progression following PARPi therapy showed a poor response to subsequent platinum-based chemotherapy, even when progression occurred more than 6 months after the penultimate platinum-based chemotherapy. This supports the theory that PARPi resistance correlates with platinum resistance and raises concern for possible contribution of PARPi in the induction of platinum resistance in recurrent EOC.

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