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Research ArticleClinical Studies

Response to Chemotherapy and Clinical Outcome of Patients With Recurrent Epithelial Ovarian Cancer After PARP Inhibitor Maintenance Treatment: A Multicenter Retrospective Italian Study

ANGIOLO GADDUCCI, STEFANIA COSIO, FABIO LANDONI, ANDREA ALBERTO LISSONI, PAOLO ZOLA, MARIA ELENA LAUDANI, ANTONIO ARDIZZOIA, ANGELA GAMBINO and ENRICO SARTORI
Anticancer Research April 2022, 42 (4) 2017-2022; DOI: https://doi.org/10.21873/anticanres.15681
ANGIOLO GADDUCCI
1Department of Clinical and Experimental Medicine, Division of Gynecology and Obstetrics, University of Pisa, Pisa, Italy;
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  • For correspondence: angiolo.gadducci@unipi.it
STEFANIA COSIO
1Department of Clinical and Experimental Medicine, Division of Gynecology and Obstetrics, University of Pisa, Pisa, Italy;
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FABIO LANDONI
2Department of Medicine and Surgery, Clinic of Obstetrics and Gynecology, San Gerardo Hospital, Monza, University of Milan Bicocca, Milan, Italy;
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ANDREA ALBERTO LISSONI
2Department of Medicine and Surgery, Clinic of Obstetrics and Gynecology, San Gerardo Hospital, Monza, University of Milan Bicocca, Milan, Italy;
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PAOLO ZOLA
3Department of Gynecology and Obstetrics, Mauriziano Hospital, University of Turin, Turin, Italy;
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MARIA ELENA LAUDANI
3Department of Gynecology and Obstetrics, Mauriziano Hospital, University of Turin, Turin, Italy;
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ANTONIO ARDIZZOIA
4Department of Oncology, Division of Medical Oncology, ASST Lecco, Lecco, Italy;
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ANGELA GAMBINO
5Department of Gynecology and Obstetrics, University of Brescia, Brescia, Italy
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ENRICO SARTORI
5Department of Gynecology and Obstetrics, University of Brescia, Brescia, Italy
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Abstract

Background/Aim: To assess response rates and survival in patients with recurrent platinum-sensitive epithelial ovarian cancer (EOC) who received PARP inhibitor (PARP-i) maintenance and who subsequently underwent salvage chemotherapy for disease progression after PARPi. Patients and Methods: This retrospective investigation analyzed 103 patients who were treated in five Italian Gynecologic centers. The PARPi used was olaparib in 46 patients, niraparib in 55, and rucaparib in 2. The interval time between the last cycle of pre- PARPi platinum–based chemotherapy and the diagnosis of progression during PARPi maintenance was defined as platinum–free interval (PFI). Results: Of the 28 patients with PFI <6 months, 23 received chemotherapy (non-platinum single agent, 20; trabectedin + pegylated liposomal doxorubicin (PLD), 3). Forty-two of the 43 patients with PFI 6-12 months underwent chemotherapy (platinum–based chemotherapy,11; trabectedin + PLD, 10; non platinum–single agent, 21). Thirty-one of the 32 patients with PFI >12 months received chemotherapy (platinum-based chemotherapy, 23; trabectedin + PLD, 3; non platinum – single agent, 5). An objective response was found in 13.0%, 26.2% and 41.9 % of the patients with PFI <6 months, 6-12 months, and >12 months (p= 0.03), respectively, and the corresponding median survivals after PARPi were 8.9 months, 17.5 months and 24.1 months (p= 0.002), respectively. Conclusion: Before the PARPi era, some randomized trials on platinum rechallenge in patients with recurrent EOC after more than 6 months from the last platinum cycle have shown response rates ranging from 47.2% to 66%. Response rates to chemotherapy for progression after PARPi appear to be lower than those expected according to PFI.

Key Words:
  • Homologous recombination
  • PARP inhibitors
  • chemotherapy
  • epithelial ovarian cancer
  • recurrence
  • Received February 7, 2022.
  • Revision received February 21, 2022.
  • Accepted March 2, 2022.
  • Copyright © 2022 International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.
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Anticancer Research: 42 (4)
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Response to Chemotherapy and Clinical Outcome of Patients With Recurrent Epithelial Ovarian Cancer After PARP Inhibitor Maintenance Treatment: A Multicenter Retrospective Italian Study
ANGIOLO GADDUCCI, STEFANIA COSIO, FABIO LANDONI, ANDREA ALBERTO LISSONI, PAOLO ZOLA, MARIA ELENA LAUDANI, ANTONIO ARDIZZOIA, ANGELA GAMBINO, ENRICO SARTORI
Anticancer Research Apr 2022, 42 (4) 2017-2022; DOI: 10.21873/anticanres.15681

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Response to Chemotherapy and Clinical Outcome of Patients With Recurrent Epithelial Ovarian Cancer After PARP Inhibitor Maintenance Treatment: A Multicenter Retrospective Italian Study
ANGIOLO GADDUCCI, STEFANIA COSIO, FABIO LANDONI, ANDREA ALBERTO LISSONI, PAOLO ZOLA, MARIA ELENA LAUDANI, ANTONIO ARDIZZOIA, ANGELA GAMBINO, ENRICO SARTORI
Anticancer Research Apr 2022, 42 (4) 2017-2022; DOI: 10.21873/anticanres.15681
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Keywords

  • Homologous recombination
  • PARP inhibitors
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  • epithelial ovarian cancer
  • recurrence
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