Fewer than half of eligible patients with advanced ovarian cancer receive second-line maintenance therapy, according to results from a real-world analysis presented at the virtual 2021 ASCO Annual Meeting.

“Although ovarian cancer represents about 1% of all new cancer cases in the US, it is the 5th leading cause of cancer death among women. Several maintenance therapies have been introduced… in this population,” wrote Robert Lawrence Reid, MD, US Oncology, Virginia Cancer Specialists, Fairfax, and colleagues.

This study aimed to estimate rates of second-line maintenance utilization among patients with advanced ovarian cancer.

The iKnowMed electronic health record database of the US Oncology Network was used to identify adult patients diagnosed with advanced ovarian cancer who received second-line platinum-containing treatment and had ≥2 visits to the database between January 2016 and July 2020. Patients were followed longitudinally until October 31, 2020, the last patient record, or date of death.

Researchers determined rates of second-line maintenance therapy for all patients, patients with a BRCA1 or BRCA2 gene alteration, and patients without a BRCA alternation.

A total of 11,494 patients were identified and 1051 were included in the study. Median follow-up from second-line platinum chemotherapy discontinuation until the end of observation was 24.6 months.

Of the 1051 patients, 538 did not receive subsequent maintenance therapy and 513 (49%) received subsequent maintenance therapy: 271 (26%) PARP inhibitors, 294 (28%) bevacizumab, 32 (3%) a non-platinum chemotherapy.

Over the study period, researchers reported no increase in the proportion of patients eligible for second-line maintenance. In 2017, 2018, and 2019, the proportion of patients who received second-line maintenance were 53%, 58%, and 56%, respectively, and the proportion of patients who did not receive maintenance were 47%, 42%, and 44%, respectively.

A documented BRCA test result was available for 662 patients who received second-line platinum chemotherapy. Of these patients, 94 (14%) had a BRCA1 or BRCA2 gene alteration and 568 (86%) did not. Among the 94 patients with a BRCA1 or BRCA2 gene alteration, 67% received second-line maintenance. Among patients without a BRCA alteration, 53% received second-line maintenance.

“Despite having several treatment options available for 2L advanced OC maintenance, fewer than half of eligible pts receive maintenance treatment,” concluded Dr Reid and colleagues.

“Although the utilization rate was higher among pts with BRCA alterations versus those without, our data suggest that there is a significant proportion of eligible pts who are not receiving maintenance therapy despite treatment guideline recommendations,” they added.—Janelle Bradley

Reid RL, Xie Y, Shi J, et al. Real-world data analysis of the utilization of second-line maintenance therapy for patients with advanced ovarian cancer. Presented at: the 2021 ASCO Annual Meeting; June 4-8, 2021; virtual. Abstract e18702.