Bjog-An International Journal of Obstetrics and Gynaecology最新文献

{"title":"Care of Women With Preterm Prelabour Rupture of the Membranes Prior to 24+0 Weeks of Gestation: Scientific Impact Paper No. 76.","authors":"M Hall, A Care, L Goodfellow, A Milan, C Curran, N Simpson, A Heazell, S Quenby, A L David, A Shennan, L Story","doi":"10.1111/1471-0528.18175","DOIUrl":"https://doi.org/10.1111/1471-0528.18175","url":null,"abstract":"<p><p>Rupture of the membranes is commonly referred to as 'waters breaking'. This usually occurs just before or during labour. In around three in 100 pregnancies it occurs before 37⁺⁰ weeks of pregnancy (preterm), but the woman does not go into labour within 24 h: this is called preterm prelabour rupture of the membranes (PPROM). These women often give birth preterm. This paper looks at PPROM before 24⁺⁰ weeks of pregnancy. This happens in a much smaller number of women. PPROM prior to 24⁺⁰ weeks of pregnancy is particularly concerning because of the chance of the baby being born extremely preterm. It is considered in the best interest of the baby not to offer resuscitation and intensive care if they are born before 22⁺⁰ weeks, meaning that these babies do not survive. Babies born between 22⁺⁰ and 26⁺⁰ weeks are at risk of severe and sometimes life-long problems. They also have a lower chance of survival than babies born later. Women sometimes develop an infection after PPROM, which can be extremely dangerous. If this happens, doctors will discuss ending the pregnancy even if the baby is very unlikely survive so that the woman does not become unwell (termination for a medical reason). However, some babies do survive and are discharged home, well, and most mothers have no long-term physical problems. This situation is very difficult for women who are pregnant, as well as their partners and wider families. It is made more difficult by a lack of clear information for doctors and midwives about how well women and babies in this situation will do, and how to look after them. This can result in lots of variation in information and care for women. Here we summarise the current evidence about this condition. Firstly, we explain available information on how well women and babies are likely to do. Then we discuss evidence about predicting the problems individual women and babies might have. Finally, we look at evidence on the ways in which healthcare professionals can care for women and their babies up to birth.</p>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Author Reply.","authors":"Marcelo de França Moreira, Marco Aurelio Pinho Oliveira","doi":"10.1111/1471-0528.18240","DOIUrl":"https://doi.org/10.1111/1471-0528.18240","url":null,"abstract":"","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of Spontaneous Preterm Birth in a Subsequent Pregnancy After Full Dilatation Caesarean Birth: A Nationwide Cohort Study.","authors":"Sara Acker, Catharina Hein Hoffmann, Lea Kirstine Hansen, Julie Glavind, Maria Jeppegaard, Lone Krebs","doi":"10.1111/1471-0528.18225","DOIUrl":"https://doi.org/10.1111/1471-0528.18225","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the association between caesarean birth in the second stage of labour and the risk of spontaneous preterm birth in a subsequent pregnancy.</p><p><strong>Design: </strong>Nationwide register-based cohort study.</p><p><strong>Setting: </strong>The Danish Medical Birth Registry and The Danish National Patient Register from 1997 to 2021.</p><p><strong>Population: </strong>Women with at least two consecutive births (index birth and subsequent birth) where the index birth was a term singleton.</p><p><strong>Methods: </strong>Women with spontaneous preterm subsequent birth were compared according to the mode of index birth, including vaginal, prelabour caesarean, first stage caesarean and second-stage caesarean. Statistical analysis was performed using multiple logistic regression.</p><p><strong>Main outcome measure: </strong>Spontaneous birth before 37 + 0 gestational weeks.</p><p><strong>Results: </strong>A total of 376 414 women met the inclusion criteria. Distribution of mode of index birth was vaginal 318 117 (84.5%), prelabour caesarean 15 373 (4.1%), first stage caesarean 37 547 (10.0%) and second-stage caesarean 5377 (1.4%), respectively. The rate of subsequent preterm birth was 1.7%. Compared to vaginal birth, a second-stage caesarean was associated with an increased risk of preterm birth in a subsequent pregnancy (adjusted odds ratio [aOR] 1.46, 95% confidence interval [CI] 1.21-1.77). Similarly, compared to first stage caesarean, a second-stage caesarean was associated with an increased risk of preterm birth in the subsequent pregnancy, with an aOR of 1.41 (95% CI 1.15-1.74).</p><p><strong>Conclusion: </strong>Second-stage caesarean in a previous term pregnancy is associated with an increased risk of spontaneous preterm birth in a subsequent pregnancy.</p>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to “Predicting Preterm Birth: An Evolving Landscape”","authors":"","doi":"10.1111/1471-0528.18183","DOIUrl":"10.1111/1471-0528.18183","url":null,"abstract":"<p>\u0000 <span>Fox, C.</span> and <span>Shennan, A.</span> (<span>2025</span>), <span>Predicting Preterm Birth: An Evolving Landscape</span>. <i>BJOG</i>, <span>132</span>: <span>672</span>–<span>673</span>. https://doi.org/10.1111/1471-0528.18067\u0000 </p><p>We apologize for this error.</p>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 8","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.18183","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144122295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disparities in Stillbirths in England: Analysis of A Population-Based Study of 1.3 Million Births","authors":"Ggenga Kayode,&nbsp;Baskaran Thilaganathan,&nbsp;Christy Burden,&nbsp;Amy Howell,&nbsp;Vincent Cheng,&nbsp;Jane Sandall,&nbsp;Maria Viner,&nbsp;Lia Brigante,&nbsp;Dilly Anumba,&nbsp;Cathy Winter,&nbsp;Birte Harlev-Lam,&nbsp;Timothy Draycott,&nbsp;Andrew Judge,&nbsp;Erik Lenguerrand,&nbsp;Tommy's National Centre for Maternity Improvement","doi":"10.1111/1471-0528.18147","DOIUrl":"10.1111/1471-0528.18147","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To examine the variation in stillbirth rates between different ethnic and socioeconomic groups within each organisational hospital group (health trust).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>National registry study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>All health trusts (HT) in National Health Service England.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Population</h3>\u0000 \u0000 <p>All mothers and babies born between April 2015 and March 2017.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This observational study examined ethnic and socioeconomic disparities in stillbirth rates for 1 268 367 births in 133 HTs compared to the national average.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Outcome</h3>\u0000 \u0000 <p>Stillbirth at or after 24 gestational weeks.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The average stillbirth rates ranged from 3.4/1000 births for White women up to 7.1/1000 births for Black women. The rates ranged from 2.9/1000 births for women living in the least deprived areas to 4.7/1000 births for those in the most deprived. The proportions of HTs with stillbirth rates well above the national average (more than 2 standard deviations) for White, Asian and Black women were 0.8%, 21.8% and 38.6%, respectively. When HTs were ranked by stillbirth rate, there were notable variations, with some trusts demonstrating lower than average stillbirth rates for White women while concurrently having higher than average stillbirth rates for Asian and/or Black women. There were no units exhibiting lower than national average stillbirth rates for Asian/Black women while concurrently having higher than average stillbirth rates for White women.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These findings suggest that access to and delivery of maternity care vary depending on the mother's ethnicity and level of socioeconomic deprivation. Social factors are likely determinants of inequality in stillbirth rather than maternity care alone.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 8","pages":"1130-1138"},"PeriodicalIF":4.7,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.18147","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Practice of Poly (ADP-Ribose) Polymerase Inhibitors for Maintenance Treatment of Platinum-Sensitive Recurrent Ovarian Cancer in China","authors":"Zhuyan Shao,&nbsp;Qiang Wen,&nbsp;Xi Chen,&nbsp;Junjie Hong,&nbsp;Wen Yu,&nbsp;Haifei Zhou,&nbsp;Yuyang Zhu,&nbsp;Tao Zhu","doi":"10.1111/1471-0528.18182","DOIUrl":"10.1111/1471-0528.18182","url":null,"abstract":"<div>\u0000 \u0000 <p>Clinical trials of three poly (ADP-ribose) polymerase (PARP) inhibitors, olaparib, niraparib and fuzuloparib, in platinum-sensitive recurrent ovarian cancer (PSR OC) in China showed that PARP inhibitors improved progression-free survival and achieved an all-comer indication in this population. We reviewed the efficacy and safety of these PARP inhibitors in patient populations studied in clinical trials and highlighted the positive role of PARP inhibitors in improving patient outcomes using clinical trials and real-world studies conducted in China. This article also discusses the issues encountered in clinical practice and how to evaluate the different indications for PSR OC in China and abroad.</p>\u0000 </div>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 S4","pages":"13-19"},"PeriodicalIF":4.7,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143897833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Maintenance Therapy With Adjuvant Chemotherapy of Three Steps in Patients Newly Diagnosed With Advanced Ovarian Cancer: A Phase II Randomised Clinical Trial","authors":"Zhong Zheng,&nbsp;Huayin Wang,&nbsp;Huijuan Yang,&nbsp;Jie Tang,&nbsp;Xi Cheng,&nbsp;Meiqin Zhang,&nbsp;Yulan Ren,&nbsp;Xiaojun Chen,&nbsp;Xinzhu Ju,&nbsp;Liya Xu,&nbsp;Xiaohua Wu","doi":"10.1111/1471-0528.18178","DOIUrl":"10.1111/1471-0528.18178","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate the efficacy and safety of adjuvant chemotherapy of three steps (ACTS) in patients newly diagnosed with advanced ovarian cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Randomised clinical trial.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>The study was conducted at a single centre.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Population</h3>\u0000 \u0000 <p>Newly diagnosed patients with advanced ovarian cancer who showed a complete response to standard chemotherapy (paclitaxel plus carboplatin) were included in this study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this open-label phase II trial, patients were randomised 1:1 to receive either ACTS therapy or no maintenance treatment. The ACTS group received step-2 chemotherapy with cyclophosphamide and etoposide (six cycles) and step-3 chemotherapy with cyclophosphamide and carboplatin (six cycles). Key endpoints were overall survival (OS), progression-free survival (PFS) and adverse events.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measures</h3>\u0000 \u0000 <p>The main outcome measures were OS, PFS and adverse events.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 130 enrolled patients, 65 were assigned to the ACTS group and 65 to the control group. The median OS in the ACTS group was 61.2 months, and patients in the ACTS group had a significantly longer PFS than those in the control group (22.2 vs. 9.73 months). The most common grade ≥ 3 adverse events were thrombocytopenia and neutropenia. No treatment-related deaths occurred during the study period.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The Maintenance ACTS Regimen Improved PFS but Not OS and Showed a Tolerable Safety Profile in Patients Newly Diagnosed With Advanced Ovarian cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>ClinicalTrials.org NCT02562365</p>\u0000 </section>\u0000 </div>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 S4","pages":"52-61"},"PeriodicalIF":4.7,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143880335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Secondary Cytoreductive Surgery for Ovarian Cancer With Second Platinum-Sensitive Recurrence: A Multicentre Retrospective Cohort Study","authors":"Yuxi Zhao,&nbsp;Zhihao Jiang,&nbsp;Tao Guo,&nbsp;Meiting Cao,&nbsp;Jia Zeng,&nbsp;Rongshou Zheng,&nbsp;Yangchun Sun,&nbsp;Guangwen Yuan,&nbsp;Ning Li,&nbsp;Guihua Shen,&nbsp;Qiubo Lv,&nbsp;Linlin Ma,&nbsp;Yi Zhang,&nbsp;Hongwei Zhao,&nbsp;Jundong Li,&nbsp;Lingying Wu","doi":"10.1111/1471-0528.18184","DOIUrl":"10.1111/1471-0528.18184","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To compare survival outcomes between patients with ovarian cancer with platinum-sensitive recurrence (PSR) who underwent secondary cytoreductive surgery (SCS) at the first recurrence and those who underwent SCS at the second recurrence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Multicentre cohort study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Data were retrospectively collected from five hospitals in China.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Population</h3>\u0000 \u0000 <p>Patients with ovarian cancer who underwent SCS at either the first or second PSR.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Overall survival (OS) and time to second progression (PFS2), calculated from the time of recurrence to the next progression following SCS, were compared between the groups. Postsurgical complications were categorised according to the Clavien–Dindo classification system.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measures</h3>\u0000 \u0000 <p>OS, PFS2, and postsurgical complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among the 231 patients included, 175 underwent SCS at the first PSR (Group 1) while 56 underwent SCS at the second PSR (Group 2). Complete resection was achieved in 84.0% of patients in Group 1 and 78.6% in Group 2. Postsurgical complication rates were similar between the groups. The median OS was not reached in Group 1, whereas Group 2 had a median OS of 77.3 months. Patients who underwent SCS at the second PSR had an OS comparable to that of those who underwent SCS at the first PSR. Multivariate analyses revealed that complete resection (hazard ratio [HR] = 0.120, <i>p</i> = 0.002) and optimal resection (HR = 0.228, <i>p</i> = 0.046) were independently associated with improved survival.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>SCS is a safe and effective treatment for patients with platinum-sensitive recurrent ovarian cancer, regardless of whether it is performed at the first or second recurrence.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 S4","pages":"36-44"},"PeriodicalIF":4.7,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143875983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PARP Inhibitors Rechallenge in Patients With Recurrent Ovarian Cancer: A Multicentre Real-World Study in China","authors":"Jin Li,&nbsp;Lingjun Zhao,&nbsp;Fei Zheng,&nbsp;Hua Zhu,&nbsp;Enchun Li,&nbsp;Wei Zhou,&nbsp;Guorong Yao,&nbsp;Jie Liu,&nbsp;Jianxiao Zheng,&nbsp;Shan Pan,&nbsp;Jinghui Hu,&nbsp;Feng Shao,&nbsp;Xiaohua Wu","doi":"10.1111/1471-0528.18181","DOIUrl":"10.1111/1471-0528.18181","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate the treatment pattern, outcomes, safety and identify patient populations benefiting from PARP inhibitor (PARPi) rechallenge for recurrent ovarian cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>A multicentre, retrospective, real-world study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Twelve hospitals in China.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Population</h3>\u0000 \u0000 <p>Seventy patients with recurrent ovarian cancer underwent PARPi rechallenge between 1 June 2019 and 10 March 2023.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data, including demographic, clinical characteristics and treatment-related information, were retrospectively collected from electronic health records.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measures</h3>\u0000 \u0000 <p>The primary outcome was progression-free survival (PFS) of PARPi rechallenge (PARPi2) as maintenance therapy. We also conducted exploratory analysis to identify factors influencing PFS and characteristics associated with favourable outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 70 patients, 37.1% had BRCA1/2 mutations. PARPi2 was used as a maintenance therapy in 81.4% of patients, with a median PFS of 8.6 months (95% confidence interval [CI]: 6.0–13.5). PFS did not significantly differ by <i>BRCA</i> status (hazard ratio = 1.25 [95% CI: 0.60–2.60], <i>p</i> = 0.55). Achieving complete response (CR) to the last chemotherapy was a significant predictor for receiving PARPi2 for ≥ 6 months (vs. partial response, odds ratio = 4.25 [95% CI: 1.21–14.9], <i>p</i> = 0.02). Patients receiving combination therapies (33.3%) had longer median PFS than those receiving monotherapy (11.0 [95% CI: 5.2–15.3] vs. 7.7 [95% CI: 5.0–13.5] months). Overall, 2.9% of patients discontinued PARPi2 due to adverse events.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>PARPi rechallenge as maintenance therapy may be feasible and tolerable. Achieving CR after the last chemotherapy is associated with longer PFS and combined therapies may improve outcomes, indicating potential to overcome PARPi resistance.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 S4","pages":"45-51"},"PeriodicalIF":4.7,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143875871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combination of PARP Inhibitor and Antiangiogenic Therapy Following Disease Progression in Patients With Epithelial Ovarian Cancer Undergoing PARP Inhibitor Maintenance Therapy: A Real-World Study","authors":"Nan Zhang,&nbsp;Hong Zheng,&nbsp;Yunong Gao,&nbsp;Tong Shu,&nbsp;Hongguo Wang,&nbsp;Yan Cai","doi":"10.1111/1471-0528.18179","DOIUrl":"10.1111/1471-0528.18179","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To investigate whether the combination of antiangiogenic therapy and poly-ADP-ribose polymerase inhibitors (PARPi) can enhance the effectiveness of maintenance therapy in patients with progressive ovarian cancer who are progressing after PARPi maintenance therapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Retrospective cohort study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Single-centre tertiary hospital in Beijing, China.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Population</h3>\u0000 \u0000 <p>Patients treated with combination therapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively reviewed the clinicopathological data of patients with epithelial ovarian cancer. Telephone follow-ups were performed for eligible participants to verify disease progression and survival status.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measures</h3>\u0000 \u0000 <p>Clinical endpoints included objective response rate (ORR), disease control rate (DCR), time-to-symptomatic progression (TTSP), and progression-free survival.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall, 25 patients were analysed. Overall confirmed ORR was 44%, and the DCR was 68%. The median TTSP was 12.0 months (95% CI: 2.05–24.73). In the progression-free interval (PFI) &gt; 12 months group (<i>n</i> = 15), the ORR was 60% (9/15), and the DCR was 73.3%. In the PFI ≤ 12 months group (<i>n</i> = 10), the ORR was 20% (2/10), and the DCR was 60%. The median TTSP was not reached in the PFI &gt; 12 months group and was 4.0 months (95% CI: 2.988–5.012) for the PFI ≤ 12 months group. The 6-month progression-free survival rates were 58% and 40%, respectively. Among the 10 patients who received subsequent chemotherapy, seven achieved partial response (PR), and one had stable disease. The respective ORR and DCR values were 70% and 80%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Combining antiangiogenic therapy with the original PARPi may benefit patients with ascites-free ovarian cancer and a low tumour burden who experience disease progression following PARPi maintenance therapy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 S4","pages":"29-35"},"PeriodicalIF":4.7,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143862175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}