PT  - JOURNAL ARTICLE
AU  - Sabrina Chiara Cecere
AU  - Lucia Musacchio
AU  - Michele Bartoletti
AU  - Vanda Salutari
AU  - Laura Arenare
AU  - Domenica Lorusso
AU  - Graziana Ronzino
AU  - Rossella Lauria
AU  - Gennaro Cormio
AU  - Emanuele Naglieri
AU  - Paolo Scollo
AU  - Claudia Marchetti
AU  - Francesco Raspagliesi
AU  - Stefano Greggi
AU  - Saverio Cinieri
AU  - Alice Bergamini
AU  - Michele Orditura
AU  - Giorgio Valabrega
AU  - Giovanni Scambia
AU  - Fabio Martinelli
AU  - Elisabetta De Matteis
AU  - Cinzia Cardalesi
AU  - Vera Loizzi
AU  - Giorgia Perniola
AU  - Claudia Carella
AU  - Giuseppa Scandurra
AU  - Gaia Giannone
AU  - Sandro Pignata
TI  - Cytoreductive surgery followed by chemotherapy and olaparib maintenance in BRCA 1/2 mutated recurrent ovarian cancer: a retrospective MITO group study
AID  - 10.1136/ijgc-2020-002343
DP  - 2021 May 13
TA  - International Journal of Gynecologic Cancer
PG  - ijgc-2020-002343
4099  - http://ijgc.bmj.com/content/early/2021/06/03/ijgc-2020-002343.short
4100  - http://ijgc.bmj.com/content/early/2021/06/03/ijgc-2020-002343.full
AB  - Introduction The role of cytoreductive surgery in the poly-ADP ribose polymerase inhibitors era is not fully investigated. We evaluated the impact of surgery performed prior to platinum-based chemotherapy followed by olaparib maintenance in platinum-sensitive BRCA-mutated recurrent ovarian cancer.Methods This retrospective study included platinum-sensitive recurrent ovarian cancer BRCA-mutated patients from 13 Multicenter Italian Trials in Ovarian cancer and gynecological malignancies centers treated between September 2015 and May 2019. The primary outcomes were progression-free survival and overall survival. Data on post-progression treatment was also assessed.Results Among 209 patients, 72 patients (34.5%) underwent cytoreductive surgery followed by platinum-based chemotherapy and olaparib maintenance, while 137 patients (65.5%) underwent chemotherapy treatment alone. After a median follow-up of 37.3 months (95% CI: 33.4 to 40.8), median progression-free survival in the surgery group was not reached, compared with 11 months in patients receiving chemotherapy alone (P<0.001). Median overall survival was nearly double in patients undergoing surgery before chemotherapy (55 vs 28 months, P<0.001). Post-progression therapy was assessed in 127 patients: response rate to chemotherapy was 29.2%, 8.8%, and 9.0% in patients with platinum-free interval >12 months, between 6 and 12 months, and <6 months, respectively.Conclusion Cytoreductive surgery performed before platinum therapy and olaparib maintenance was associated with longer progression-free survival and overall survival in BRCA-mutated platinum-sensitive relapsed ovarian cancer patients. In accordance with our preliminary results, the response rate to chemotherapy given after progression during olaparib was associated with platinum-free interval.All data relevant to the study are included in the article or uploaded as supplementary information.