Efficacy and safety of an oral combination therapy of niraparib and etoposide in platinum resistant/refractory ovarian cancer: a single arm, prospective, phase II study.

IF 4.1 2区 医学 Q1 OBSTETRICS & GYNECOLOGY
Huimei Zhou, Qian Liu, Depu Zhang, Qingshui Li, Dongyan Cao, Ninghai Cheng, Xirun Wan, Ying Zhang, Fengzhi Feng, Yang Xiang, Jiaxin Yang
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引用次数: 0

Abstract

Objective: Non-platinum chemotherapy is used in platinum resistant/refractory ovarian cancer patients but offers limited efficacy, especially in those who develop platinum resistance after ≤2 lines of platinum based chemotherapy. This phase II study aimed to evaluate the efficacy and safety of oral niraparib plus etoposide in platinum resistant/refractory ovarian cancer.

Methods: Platinum resistant/refractory ovarian cancer patients after ≤2 lines of platinum based chemotherapy, histologically confirmed as non-mucinous epithelial ovarian cancer, regardless of biomarker status, were eligible. Patients received niraparib with a starting dose of 200 mg/100 mg alternate once a day, and oral etoposide of 50 mg once a day, on days 1-20 of 30 days per cycle for a maximum of 6-8 cycles, followed by niraparib until disease progression or intolerable toxicity. The primary endpoint was investigator assessed progression free survival.

Results: 29 patients were enrolled from 22 May 2020 to 3 February 2023; 26 patients were included in the efficacy analysis set as per protocol. Median progression free survival was 4.2 months (95% confidence interval (CI) 3.9 to 4.4). Overall response rate was 26.9% (95% CI 8.7 to 45.2). Disease control rate was 57.7% (95% CI 37.3 to 78.0). Overall response rate in patients with a BRCA mutation and homologous recombination deficiency was 50% and 41.7%, respectively. Median progression free survival in patients with primary platinum resistance was 4.5 months (95% CI 3.6 to 5.3). 29 patients were included in the safety analysis set, and 8 (28%) patients experienced treatment related adverse events of grade ≥3. There was no treatment related discontinuation.

Conclusions: Niraparib combined with etoposide showed evidence of antitumor activity in platinum resistant/refractory ovarian cancer after ≤2 lines of platinum based chemotherapy, particularly in patients with a BRCA mutation, homologous recombination deficiency, or primary platinum resistance. This once-a-day oral combination was a convenient option.

Trial registration number: NCT04217798.

尼拉帕利和依托泊苷口服联合疗法对铂类耐药/难治性卵巢癌的疗效和安全性:单臂、前瞻性 II 期研究。
目的:非铂类化疗可用于铂类耐药/难治性卵巢癌患者,但疗效有限,尤其是那些铂类化疗≤2线后出现铂类耐药的患者。这项II期研究旨在评估口服尼拉帕利加依托泊苷治疗铂类耐药/难治性卵巢癌的疗效和安全性:铂类耐药/难治性卵巢癌患者在铂类化疗≤2线后,经组织学证实为非黏液上皮性卵巢癌,无论生物标记物状态如何,均符合条件。患者接受尼拉帕利治疗,起始剂量为200毫克/100毫克,每天交替一次,口服依托泊苷50毫克,每天一次,第1-20天为一个周期,每个周期30天,最多6-8个周期,然后接受尼拉帕利治疗,直到疾病进展或出现不能耐受的毒性反应。主要终点为研究者评估的无进展生存期。结果:2020 年 5 月 22 日至 2023 年 2 月 3 日,29 名患者入组;26 名患者按方案纳入疗效分析组。无进展生存期中位数为 4.2 个月(95% 置信区间 (CI) 3.9 至 4.4)。总体反应率为 26.9%(95% 置信区间为 8.7 至 45.2)。疾病控制率为 57.7%(95% 置信区间为 37.3 至 78.0)。BRCA基因突变和同源重组缺陷患者的总体反应率分别为50%和41.7%。原发性铂类耐药患者的中位无进展生存期为4.5个月(95% CI 3.6至5.3)。29名患者被纳入安全性分析组,其中8名患者(28%)出现了≥3级的治疗相关不良事件。没有出现与治疗相关的停药情况:结论:尼拉帕利与依托泊苷联合治疗铂类耐药/难治性卵巢癌显示出抗肿瘤活性,尤其是在BRCA突变、同源重组缺陷或原发性铂类耐药患者中。这种一天一次的口服复方制剂是一种方便的选择:试验注册号:NCT04217798。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
6.60
自引率
10.40%
发文量
280
审稿时长
3-6 weeks
期刊介绍: The International Journal of Gynecological Cancer, the official journal of the International Gynecologic Cancer Society and the European Society of Gynaecological Oncology, is the primary educational and informational publication for topics relevant to detection, prevention, diagnosis, and treatment of gynecologic malignancies. IJGC emphasizes a multidisciplinary approach, and includes original research, reviews, and video articles. The audience consists of gynecologists, medical oncologists, radiation oncologists, radiologists, pathologists, and research scientists with a special interest in gynecological oncology.
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