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Treatment patterns and BRCA testing practices in platinum-sensitive recurrent serous ovarian cancer: a Spanish medical record review

Date

08 Oct 2016

Session

Poster Display

Presenters

Isabel Bover

Citation

Annals of Oncology (2016) 27 (6): 296-312. 10.1093/annonc/mdw374

Authors

I. Bover1, N. Colombo2, J. Korach3, K.L. Davis4, J.A. Kaye5, J.R. Robert Lewis6, A. Callejo7, A. Gascó8

Author affiliations

  • 1 Servicio De Oncología Médica, Hospital Son Llatzer, 07198 - Palma de Mallorca/ES
  • 2 Divisione Di Ginecologia Oncologica Medica, Istituto Europeo di Oncologia, 20141 - Milano/IT
  • 3 Department Of Gynecological Oncology, Sheba Medical Center, Tel Hashomer/IL
  • 4 Health Economics, RTI Health Solutions, 02452-8413 - Waltham/US
  • 5 Epidemiology, RTI Health Solutions, 02452-8413 - Waltham/US
  • 6 Global Medical Affairs, AstraZeneca, CB2 8PA - Cambridge/GB
  • 7 Clinical Operations, APICES, 28320 - Pinto/ES
  • 8 Local Medical Affairs, AstraZeneca Spain, 28033 - Madrid/ES
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Background

Platinum-based chemotherapy is considered standard treatment for platinum-sensitive recurrent ovarian cancer (PSR OC). Real-world data on BRCA mutation (BRCAm) testing, treatment patterns and characteristics of patients (pts) diagnosed with PSR OC will help to identify unmet medical needs in this population.

Methods

We retrospectively reviewed a random sample of medical records of women having serous PSR OC after 1st-line platinum completion, during 2009-2013, to assess PSR OC treatment patterns and BRCAm testing. Study index date was defined as PSR OC diagnosis date.

Results

Data from 298 pts were collected in Spain. At diagnosis, median age: 58 years; ECOG 0, 1: 38%, 52%; advanced disease stage (≥IIb): 93%; high grade: 80%. Primary tumour sites: ovary (88%); fallopian tube (8%); primary peritoneum (4%). 70% of pts had received primary cytoreductive surgery, 88% received carboplatin + paclitaxel as 1st-line (with or without bevacizumab) (median number of cycles 6) and 4% received intraperitoneal treatment. 7% of pts received maintenance therapy after 1st-line, mainly bevacizumab (95%). The majority of pts (78%) received 2nd-line therapy: platinum based 91%; mainly carboplatin + paclitaxel (31%), gemcitabine (15%) or pegylated liposomal doxorubicin (9%); 20% concomitant bevacizumab. Median times from initial ovarian cancer diagnosis to index date and from index date to end of follow-up were 20 months. BRCA testing was performed in 83 (28%) of pts and 76 (92%) had a conclusive result available. Of those, 34% were BRCAm. 16% of total pts (69% of BRCAm pts) had family history of BRCA-related cancer (breast 81%; ovarian 41%). BRCA tests were performed on blood (76%) and tumour tissue (24%) samples. BRCA testing method unknown: 65%. When known, direct DNA sequencing was the most used BRCA testing method (16 pts, 55%).

Conclusions

Platinum-based chemotherapy for PSR OC was the standard of care in this review. Bevacizumab was associated with chemotherapy in only 20% of pts. Family history of BRCA related cancer was absent in 31% of BRCAm pts. BRCA testing was not routinely performed. Physicians were mostly unfamiliar with the BRCA testing method used; when known, direct DNA sequencing was the most commonly used method.

Clinical trial identification

ClinicalTrials.gov NCT02262273 (October 6, 2014)

Legal entity responsible for the study

AstraZeneca

Funding

AstraZeneca

Disclosure

N. Colombo: I disclosure my participation in advisory board by Astra Zeneca and corporate-sponsored trials (SOLO1, SOLO2 and ORZORA). K.L. Davis, J.A. Kaye: I am an employee of RTI Health Solutions, which received contract research funding from AstraZeneca for the implementation and conduct of this study and the analyses contained therein. J.R. Robert Lewis, A. Gascó: I'm an AstraZeneca's employee. A. Callejo: I'm an APICES's employee, working as Project Manager for AstraZeneca. All other authors have declared no conflicts of interest.

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