Maintenance Therapy Patterns for Recurrent Ovarian Cancer in Real-World Setting

Findings from a real-world study suggest that maintenance therapy following second-line or third-line platinum-based chemotherapy is becoming more common in patients with ovarian cancer, revealing insight into the shifting treatment patterns for patients with recurrent ovarian cancer (Gynecol Oncol. 2021; S0090-8258[21]00588-6. doi:10.1016/j.ygyno.2021.07.026).

Maintenance therapy for patients with platinum-sensitive recurrent ovarian cancer has shown evidence of clinical utility in several clinical trials, however, these trials did not account for real-world treatment patterns.

In order to address real-world treatment patterns for this study, Hayley Moss, MD, MBA, Duke University Medical Center, Duke Cancer Institute, Durham, NC, and colleagues used the nationwide Flatiron Health electronic health records database to assess patients diagnosed with ovarian cancer between January 1, 2011, and July 31, 2019.

Patients included in this study received second- or third-line platinum-based chemotherapy. Authors identified 2292 patients with ovarian cancer who received at least two lines of therapy.

Among these patients, there were 222 who completed platinum-based chemotherapy on or after March 1, 2017 and had at least 2 months of active surveillance or received maintenance therapy with polyadenosine diphosphate-ribose polymerase inhibitors or bevacizumab.

Of the 46 patients (20%) who had BRCA alterations, 63% received polyadenosine diphosphate-ribose polymerase inhibitors, 17% received bevacizumab, and 20% underwent active surveillance. Of the 132 patients (59%) who had a wild type gene, 40% received a polyadenosine diphosphate-ribose polymerase inhibitors, 23% received bevacizumab, and 36% underwent active surveillance. There were 47 patients (21%) who were labeled unknown.

Maintenance therapy was associated with younger age and a BRCA alteration. The use of polyadenosine diphosphate-ribose polymerase inhibitors averaged an increase of 1.3% every 3 months with no significant change in use of bevacizumab.

“In this real-world population, maintenance therapy is becoming progressively more common following 2L or 3L platinum-based chemotherapy regardless of biomarker status,” Dr Moss and colleagues concluded, adding, “the results provide insight into the shifting treatment patterns for patients with recurrent ovarian cancer.”—Marta Rybczynski