Maintenance olaparib rechallenge in patients with platinum-sensitive relapsed ovarian cancer previously treated with a PARP inhibitor (OReO/ENGOT-ov38): a phase IIIb trial

Background - Poly(ADP-ribose) polymerase (PARP) inhibitor maintenance therapy is the standard of care for some patients with advanced ovarian cancer. We evaluated the efficacy and safety of PARP inhibitor rechallenge. - Patients and methods - This randomized, double-blind, multicenter trial (NCT0310...

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Hauptverfasser: Pujade-Lauraine, Éric (VerfasserIn) , Selle, F. (VerfasserIn) , Scambia, G. (VerfasserIn) , Asselain, B. (VerfasserIn) , Marmé, Frederik (VerfasserIn) , Lindemann, K. (VerfasserIn) , Colombo, N. (VerfasserIn) , Mądry, R. (VerfasserIn) , Glasspool, R. (VerfasserIn) , Vergote, Ignace B. (VerfasserIn) , Korach, J. (VerfasserIn) , Lheureux, S. (VerfasserIn) , Dubot, C. (VerfasserIn) , Oaknin, A. (VerfasserIn) , Zamagni, C. (VerfasserIn) , Heitz, Florian (VerfasserIn) , Gladieff, L. (VerfasserIn) , Rubio-Pérez, M. J. (VerfasserIn) , Scollo, P. (VerfasserIn) , Blakeley, C. (VerfasserIn) , Shaw, B. (VerfasserIn) , Ray-Coquard, I. (VerfasserIn) , Redondo, A. (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: December 2023
In: Annals of oncology
Year: 2023, Jahrgang: 34, Heft: 12, Pages: 1152-1164
ISSN:1569-8041
DOI:10.1016/j.annonc.2023.09.3110
Online-Zugang:Verlag, kostenfrei, Volltext: https://doi.org/10.1016/j.annonc.2023.09.3110
Verlag, kostenfrei, Volltext: https://www.sciencedirect.com/science/article/pii/S0923753423040073
Volltext
Verfasserangaben:E. Pujade-Lauraine, F. Selle, G. Scambia, B. Asselain, F. Marmé, K. Lindemann, N. Colombo, R. Mądry, R. Glasspool, I. Vergote, J. Korach, S. Lheureux, C. Dubot, A. Oaknin, C. Zamagni, F. Heitz, L. Gladieff, M. J. Rubio-Pérez, P. Scollo, C. Blakeley, B. Shaw, I. Ray-Coquard & A. Redondo, on behalf of the OReO/ENGOT-ov38 investigators

MARC

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520 |a Background - Poly(ADP-ribose) polymerase (PARP) inhibitor maintenance therapy is the standard of care for some patients with advanced ovarian cancer. We evaluated the efficacy and safety of PARP inhibitor rechallenge. - Patients and methods - This randomized, double-blind, multicenter trial (NCT03106987) enrolled patients with platinum-sensitive relapsed ovarian cancer who had received one prior PARP inhibitor therapy for ≥18 and ≥12 months in the BRCA-mutated and non-BRCA-mutated cohorts, respectively, following first-line chemotherapy or for ≥12 and ≥6 months, respectively, following a second or subsequent line of chemotherapy. Patients were in response following their last platinum-based chemotherapy regimen and were randomized 2 : 1 to maintenance olaparib tablets 300 mg twice daily or placebo. Investigator-assessed progression-free survival (PFS) was the primary endpoint. - Results - Seventy four patients in the BRCA-mutated cohort were randomized to olaparib and 38 to placebo, and 72 patients in the non-BRCA-mutated cohort were randomized to olaparib and 36 to placebo; >85% of patients in both cohorts had received ≥3 prior lines of chemotherapy. In the BRCA-mutated cohort, the median PFS was 4.3 months with olaparib versus 2.8 months with placebo [hazard ratio (HR) 0.57; 95% confidence interval (CI) 0.37-0.87; P = 0.022]; 1-year PFS rates were 19% versus 0% (Kaplan-Meier estimates). In the non-BRCA-mutated cohort, median PFS was 5.3 months for olaparib versus 2.8 months for placebo (HR 0.43; 95% CI 0.26-0.71; P = 0.0023); 1-year PFS rates were 14% versus 0% (Kaplan-Meier estimates). No new safety signals were identified with olaparib rechallenge. - Conclusions - In ovarian cancer patients previously treated with one prior PARP inhibitor and at least two lines of platinum-based chemotherapy, maintenance olaparib rechallenge provided a statistically significant, albeit modest, PFS improvement over placebo in both the BRCA-mutated and non-BRCA-mutated cohorts, with a proportion of patients in the maintenance olaparib rechallenge arm of both cohorts remaining progression free at 1 year. 
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