First-line maintenance therapy use for ovarian cancer has increased over time, particularly among patients with biomarker guidance, according to a study presented at the virtual 2021 ASCO Annual Meeting.

“With the advent of [PARP inhibitors], options for first-line maintenance therapy in ovarian cancer have evolved in the US,” wrote Jinan Liu, MD, PhD, GlaxoSmithKline, Navy Yard, PA, and colleagues.

This study aimed to describe the use of first-line maintenance therapy among patients with ovarian cancer in the real-world setting, as well as assess predictors of its use.

The Flatiron Health electronic health record-derived deidentified database was used to identify patients with newly-diagnosed, stage III/IV epithelial ovarian cancer who received 6-9 cycles of first-line platinum-based chemotherapy or primary or interval debulking surgery following neoadjuvant chemotherapy between January 2016 and February 2020.

A total of 463 patients were included in the study. Of these patients, 21% received maintenance therapy and 79% received active surveillance. Over the study period, maintenance therapy use increased from 7.7% to 37.7%.

Patients with BRCA wild-type were significantly less likely (odd ratio [OR]:0.30; 95% CI, 0.16-0.59) to receive maintenance therapy than patients with BRCA mutation. In addition, patients treated in 2018 (OR: 2.73; 95% CI, 1.25-5.98) and 2019 (OR: 8.78; 95% CI, 4.15-18.55) were significantly more likely to received maintenance therapy than those treated in 2017.

Researchers noted that age, race, practice type, ECOG score, and residual disease were not significant predictors of first-line maintenance therapy use in this patient population.

“Nearly 40% of patients with advanced stage [ovarian cancer] received upfront maintenance therapy with an increasing trend over time, particularly in those with biomarker guidance,” wrote Dr Liu and colleagues.

“Research is warranted toward addressing barriers to the appropriate use of maintenance therapy,” they concluded.—Janelle Bradley

Lui J, Thaker PH, Sah J, et al. Real-world patterns and predictors of first-line maintenance use among patients with newly diagnosed advanced ovarian cancer: Is there an opportunity for change? Presented at: the 2021 ASCO Annual Meeting; June 4-8, 2021; virtual. Abstract e18710.