Maintenance Therapy Use for Recurrent Ovarian Cancer Increasing in Real-World Setting

Results of a real-world study suggest maintenance therapy is becoming more common following second-line or third-line platinum-based chemotherapy in patients with platinum-sensitive recurrent ovarian cancer, regardless of their biomarker status (Gynecol Oncol. 2021; S0090-8258[21]00588-6. doi:10.1016/j.ygyno.2021.07.026).

While several clinical trials have validated use of maintenance therapy in patients with platinum-sensitive recurrent ovarian cancer, Haley Moss, MD, MBA, Duke University Medical Center, Duke Cancer Institute, Durham, NC, and colleagues aimed to assess treatment patterns in the real-world setting.

Dr Moss and colleagues used the US nationwide Flatiron health database, an electronic health record database, to identify patients diagnosed with ovarian cancer between January 1, 2011, and July 31, 2019, who received second- or third-line platinum-based chemotherapy.

Among the patients in this study, 2292 received at least 2 lines of therapy. Authors identified 222 patients 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 poly (adenosine diphosphate-ribose) polymerase inhibitors or bevacizumab.

The database showed that 63% of patients in the BRCA mutation group received a poly(adenosine diphosphate-ribose) polymerase inhibitor, while 40% of patients in the BRCA wildtype group received this treatment. Patients who received bevacizumab totaled 17% in the BRCA mutation group, and 23% in the BRCA wildtype group. Those who underwent active surveillance in the BRCA mutation group and the BRCA wildtype group totaled 20% and 36%, respectively.

Authors noted that maintenance therapy was more common in younger patients with a BRCA mutation. While there was no significant change in the use of bevacizumab, poly(adenosine diphosphate-ribose) polymerase inhibitor use averaged a 1.3% increase every 3 months.

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