Cytoreductive surgery followed by chemotherapy and olaparib maintenance in BRCA 1/2 mutated recurrent ovarian cancer: a retrospective MITO group study. Issue 7 (14th May 2021)

• Record Type: Journal Article
• Authors: Cecere, Sabrina Chiara; Musacchio, Lucia; Bartoletti, Michele; Salutari, Vanda; Arenare, Laura; Lorusso, Domenica; Ronzino, Graziana; Lauria, Rossella; Cormio, Gennaro; Naglieri, Emanuele; Scollo, Paolo; Marchetti, Claudia; Raspagliesi, Francesco; Greggi, Stefano; Cinieri, Saverio; Bergamini, Alice; Orditura, Michele; Valabrega, Giorgio; Scambia, Giovanni; Martinelli, Fabio; De Matteis, Elisabetta; Cardalesi, Cinzia; Loizzi, Vera; Perniola, Giorgia; Carella, Claudia; Scandurra, Giuseppa; Giannone, Gaia; Pignata, Sandro
• Is Part Of: International journal of gynecological cancer. Volume 31:Issue 7(2021)
• Page Start: 1031
• Page End: 1036
• Publication Date: 2021-05-14
• Subjects: ovarian cancer -- cytoreduction surgical procedures; Generative organs, Female -- Cancer -- Periodicals; 616.99465
• DOI: 10.1136/ijgc-2020-002343
• Languages: English
• ISSNs: 1048-891X

Abstract

Abstract : Introduction: The role of cytoreductive surgery in the poly-ADP ribose polymerase inhibitors era is not fully investigated. We evaluated the impact of surgery performed prior to platinum-based chemotherapy followed by olaparib maintenance in platinum-sensitive BRCA-mutated recurrent ovarian cancer. Methods: This retrospective study included platinum-sensitive recurrent ovarian cancer BRCA-mutated patients from 13 Multicenter Italian Trials in Ovarian cancer and gynecological malignancies centers treated between September 2015 and May 2019. The primary outcomes were progression-free survival and overall survival. Data on post-progression treatment was also assessed. Results: Among 209 patients, 72 patients (34.5%) underwent cytoreductive surgery followed by platinum-based chemotherapy and olaparib maintenance, while 137 patients (65.5%) underwent chemotherapy treatment alone. After a median follow-up of 37.3 months (95% CI: 33.4 to 40.8), median progression-free survival in the surgery group was not reached, compared with 11 months in patients receiving chemotherapy alone (P<0.001). Median overall survival was nearly double in patients undergoing surgery before chemotherapy (55 vs 28 months, P<0.001). Post-progression therapy was assessed in 127 patients: response rate to chemotherapy was 29.2%, 8.8%, and 9.0% in patients with platinum-free interval >12 months, between 6 and 12 months, and <6 months, respectively. Conclusion: Cytoreductive surgery performed before platinum therapy and olaparib maintenance was associated with longer progression-free survival and overall survival in BRCA-mutated platinum-sensitive relapsed ovarian cancer patients. In accordance with our preliminary results, the response rate to chemotherapy given after progression during olaparib was associated with platinum-free interval.