Disease Progression After Olaparib Maintenance Prognosticates Poor Response to Subsequent Platinum-Based Chemotherapy in Ovarian Cancer

The efficiency of re-administration of platinum-based chemotherapy for patients with platinum-sensitive, recurrent ovarian cancer with a short-term recurrence after olaparib maintenance may need to be reconsidered, according to a recent study (J Obstet Gynaecol Res. 2022. doi:10.1111/jog.15184).

The study, conducted by Hiroshi Nakazawa, MD, Department of Gynecologic Oncology, Hyogo Cancer Center, Akashi, Hyogo, Japan, and colleagues, aimed to clarify whether platinum-based chemotherapy would be impaired at the time of recurrence after olaparib maintenance therapy in patients with platinum-sensitive, recurrent ovarian cancer.

This noninterventional retrospective study included 42 patients with platinum-sensitive, recurrent ovarian cancer who received olaparib after second- or later-line of platinum-based chemotherapy between April 18, 2018, and August 31, 2021. The effects of olaparib maintenance therapy on platinum-based chemotherapy after progression were analyzed. 

Among participants, 24 relapsed after olaparib maintenance therapy, and 17 patients received platinum-based chemotherapy again, with 4 or 17 responding to the platinum-based chemotherapy (complete response [n = 2], partial response [n = 2]). The median progression-free survival was 9.7 months in patients with platinum-free interval ≥12 months, and 2.6 months in patients with platinum-free interval of 6 to 12 months (P = .04).

“In the patients with PSROC [platinum-sensitive, recurrent ovarian cancer] who experienced disease progression after olaparib maintenance therapy, especially in those with platinum-free interval of 6-12 months, the response to subsequent PBC [platinum-based chemotherapy] was extremely poor,” concluded Dr Nakazawa and colleagues, adding, “The efficiency of re-administration of PBC for PSROC patients with a short-term recurrence after olaparib treatment may need to be reconsidered.”