PARP Inhibitors Rechallenge in Patients With Recurrent Ovarian Cancer: A Multicentre Real-World Study in China

Objective

To evaluate the treatment pattern, outcomes, safety and identify patient populations benefiting from PARP inhibitor (PARPi) rechallenge for recurrent ovarian cancer.

Design

A multicentre, retrospective, real-world study.

Setting

Twelve hospitals in China.

Population

Seventy patients with recurrent ovarian cancer underwent PARPi rechallenge between 1 June 2019 and 10 March 2023.

Methods

Data, including demographic, clinical characteristics and treatment-related information, were retrospectively collected from electronic health records.

Main Outcome Measures

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.

Results

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 BRCA status (hazard ratio = 1.25 [95% CI: 0.60–2.60], p = 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], p = 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.

Conclusions

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.