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06. Ovarian cancer
586 Multicenter real-life data of subsequent chemotherapy after progression to niraparib in a maintenance relapse setting
  1. Floriana Camarda1,
  2. Lucia Musacchio1,
  3. Marilena Di Napoli2,
  4. Gabriella Ferrandina3,
  5. Alice Bergamini4,
  6. Roberto Angioli5,
  7. Carmine De Angelis6,
  8. Vittoria Barberi7,
  9. Laura Zavallone8,
  10. Vanda Salutari3,
  11. Francesco Raspagliesi9,
  12. Alberto Farolfi10,
  13. Giorgia Perniola11,
  14. Stefania Gori12,
  15. Sabrina Chiara Cecere13,
  16. Eleonora Palluzzi1,
  17. Rossella Lauria6,
  18. Sandro Pignata14,
  19. Giovanni Scambia1 and
  20. Domenica Lorusso1
  1. 1Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
  2. 2Istituto Nazionale Tumori Fondazione G Pascale IRCCS, Napoli, Italy
  3. 3Fondazione Policlinico Universitario A.Gemelli IRCCS, Rome, Italy
  4. 4Faculty of Medicine, Università Vita salute San Raffaele Milano, Milano, Italy
  5. 5Allegheny Health Network, Rome, Italy
  6. 6Università Federico II, Napoli, Italy
  7. 7IFO – Istituto Nazionale Tumori Regina Elena, Roma, Italy
  8. 8Azienda Sanitaria Locale, Biella, Italy
  9. 9Fondazione IRCCS Istituto Nazionale dei Tumori, Gynecological Oncology Unit, Milan, Italy
  10. 10IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST), Meldola, Italy
  11. 11Sapienza University of Rome, Roma, Italy
  12. 12IRCCS Ospedale Sacro Cuore Don Calabria, Verona, Italy
  13. 13Pascale National Cancer Institute Foundation (IRCCS), Napoli, Italy
  14. 14Department of Urology and Gynecology, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Napoli, Italy

Abstract

Introduction/Background Despite impressive progression free survival (PFS) results from PARP inhibitors (PARPi) in ovarian cancer (OC), concerns about their effect on post-progression treatment outcomes have recently arisen, particularly in the relapsed setting. Mechanisms of overlapping resistance between PARPi and platinum have been suggested, and optimal therapy after PARPi progression is unknown. The aim of this study is to describe outcomes of subsequent chemotherapy after niraparib progression in recurrent platinum sensitive OC, focusing both on platinum rechallenge and no platinum-based chemotherapy.

Methodology In this exploratory analysis, data from high-grade serous or endometrioid OC patients who received subsequent chemotherapy after progression to niraparib in the recurrent setting in 17 MITO centers, were collected and analyzed. Primary endpoint of this analysis was overall response rate (ORR).

Results Two hundred and thirty-one patients with progressive disease to niraparib were included in this study: 101 patients had a platinum free interval (PFI) of less than 6 months and 130 patients a PFI > 6 months. Among these, 136 women (59%) were evaluable for response to the subsequent chemotherapy after progression on niraparib. In the group of patients with PFI < 6 months weekly paclitaxel was the most frequently administered regimen (37.3%) and ORR was 10.4%, while the ORR in the group of patients with PFI > 6 months was 26.3% (2 CR and 14 PR) and clinical benefit rate (CBR) was 47.6%. Fifty-five patients in this group received platinum-based chemotherapy and reported an ORR of 29%. The remaining 16 women with PFI >6 months were treated with pegylated liposomal doxorubicin (PLD) in combination with trabectedin: no responses were reported in this cohort of patients.

Conclusion Patients who experienced disease progression following niraparib treatment showed a poor response to subsequent platinum-based chemotherapy, even when progression occurred more than 6 months after completion of their penultimate platinum-based chemotherapy.

Disclosures The authors declare no disclosures.

https://doi.org/10.1136/ijgc-2024-ESGO.678

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