Giorgia Russo, Adriana Ionelia Apostol, Ilary Ruscito, Carolina Maria Sassu, Claudia Diella, Fabiana Salvati, Filippo Maria Capomacchia, Serena Maria Boccia, Laura Vertechy, Christian Marth, Anna Fagotti, Claudia Marchetti
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引用次数: 0
Abstract
Objective: In BRCA-mutated (BRCAmut) patients, while sensitivity to platinum has been assessed, the efficacy of other chemotherapy drugs, such as paclitaxel, in the recurrent setting is less defined. To this purpose, a single-center retrospective study was designed to evaluate the effects of paclitaxel monotherapy in patients with platinum-resistant ovarian cancer based on BRCA status.
Methods: We collected data on patients with recurrent high-grade epithelial ovarian cancer treated with paclitaxel monotherapy between November 2017 and October 2024. Only patients who received 2 to 4 previous lines of chemotherapy before paclitaxel were selected. BRCAmut patients were compared with BRCA wild-type (BRCAwt) patients. The primary outcome was the impact of paclitaxel monotherapy on overall survival in both groups separately. The secondary outcomes were progression-free survival, response rate, and toxicity profile.
Results: Of 175 patients who received paclitaxel, 155 met the inclusion criteria: 50 (32.3%) BRCAmut and 105 (67.7%) BRCAwt patients. Median progression-free survival was 5 months (95% confidence interval [CI] 3.58 to 6.42) in the BRCAwt group compared with 4 months (95% CI 2.29 to 5.71) in the BRCAmut group (p = .013). In BRCAmut patients, median overall survival was 11 months (95% CI 8.28 to 13.72) compared with 18 months for the BRCAwt group (95% CI 16.04 to 19.96) (p < .001). In the 93 patients who had previously received poly (ADP-ribose) polymerase (PARP) inhibitors, overall survival remained significantly longer in BRCAwt patients (p = .004), but not progression-free survival (p > .05).
Conclusions: Treatment with paclitaxel monotherapy seems to be less effective in patients with recurrent platinum-resistant BRCAmut ovarian cancer compared with the BRCAwt population. Further clinical studies are needed to confirm these data and investigate potential mechanisms of paclitaxel resistance in BRCAmut carriers.
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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