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380 Real world clinical outcomes of niraparib first line maintenance therapy in patients with BRCA wildtype advanced ovarian cancer
  1. Sabrina Piedimonte1,
  2. Lauren Clarfield2,
  3. Mollie Manley2 and
  4. Rachel Kupets3
  1. 1Hopital Maisonneuve Rosemont, Montreal, Canada
  2. 2University of Toronto, Toronto, Canada
  3. 3Sunnybrook Health Sciences Center, Toronto, Canada

Abstract

Introduction/Background First-line maintenance parp-inhibitor therapy has shown improved progression free survival in patients with BRCA mutated advanced ovarian cancer. However, in BRCA wildtype/HRD unknown patients, the magnitude of benefit is to a lesser extent with significant adverse events. Our goal was to evaluate whether there is a significant difference in progression free survival between patients with BRCA wildtype/HRD unknown advanced ovarian cancer treated with niraparib in the first line maintenance setting compared to patients who did not.

Methodology This is a single center retrospective cohort study of BRCA wildtype advanced ovarian cancer patients treated at Sunnybrook Health Sciences Center from January 2020-February 2022. The treatment group received niraparib as maintenance in the first line setting while controls did not.Homologous recombination deficiency (HRD) status was unknown. Descriptive statistics were performed on demographic parameters. PFS was analyzed using Kaplan Meier analysis. Cox proportional hazards was done to adjust for confounders.

Results Among 139 patients BRCAwildtype/HRD unknown patients during the study period, 52 received niraparib in the first line and 38 who did not. There was no significant difference in age(p=0.177), stage(p=0.345), histology(0.221), number of neoadjuvant chemotherapy cycles(p=0.187), and outcome of cytoreduction(p=0.270).

The median progression free survival was 12.99 months(95% CI: 5.21–20.77) in the niraparib group and 18.61 months (95% CI: 15.93–21.29) in controls (p=0.143).

At 1 year the proportion of patients that were progression free was 29/52 (56%) in the niraparib group and 34/38 (0.89) in the control (p=.001) while at 2 years it was respectively 24/29 (83%) and 13/34 (38%) (p<.001). Among patients with adverse effects, 20/43 (47%) had thrombocytopenia and 8/43 (19%) neutropenia.

Conclusion In our cohort of BRCA wildtype/HRD mutated patients, there was no significant difference in median PFS between those who received niraparib in the first line versus those who did not with high rates of adverse events.

Disclosures No disclosures to report.

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