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Poster display session

4012 - Impact of chemotherapy (CT) in heavily pretreated BRCA1/2 mutation carrier ovarian cancer (BMCOC) patients (pts)

Date

09 Sep 2017

Session

Poster display session

Topics

Cytotoxic Therapy;  Ovarian Cancer

Presenters

Victor Rodriguez Freixinos

Citation

Annals of Oncology (2017) 28 (suppl_5): v330-v354. 10.1093/annonc/mdx372

Authors

V. Rodriguez Freixinos1, L. Fariñas Madrid1, M. Gil Martin2, P. Barretina3, M. Romeo Marin4, G. Villacampa Javierre5, C. VIAPLANA6, B. Pardo2, H. Ahmed Ouahid3, S. Recalde7, J.M. Piulats Rodriguez8, M.C. Gomez9, A. Gil-Moreno10, E. Sala11, S. Martinez-Román12, C. Melendez3, E. Carballas12, R. Dienstmann13, A. Oaknin1

Author affiliations

  • 1 Medical Oncology Department, Vall d'Hebron University Hospital, Vall d’Hebron Institute of Oncology (VHIO), 08035 - Barcelona/ES
  • 2 Medical Oncology, Institut Català D'Oncologia,, Barcelona/ES
  • 3 Medical Oncology, Catalan Institute of Oncology (ICO)-Hospital Universitari Josep Trueta, 17007 - Girona/ES
  • 4 Medical Oncology, Catalan Institute of Oncology (ICO Badalona), Hospital Germans Trias i Pujol, 8916 - Badalona/ES
  • 5 Oncology Data Science (odyssey) Group, Vall d'Hebron Institute of Oncology, 08035 - Barcelona/ES
  • 6 Oncology Data Science Group (odyssey), Vall d'Hebron Institute of Oncology (VHIO), 08035 - Barcelona/ES
  • 7 Medical Oncology, Catalan Institute of Oncology, 08907 - L'Hospitalet/ES
  • 8 Medical Oncology, Institut Catala de Oncologia, 8907 - Barcelona/ES
  • 9 Pathology Department, Catalan Institute of Oncology (ICO Badalona), Hospital Germans Trias i Pujol, 8916 - Badalona/ES
  • 10 Gynaecology, Vall d'Hebron University Hospital, 08035 - Barcelona/ES
  • 11 Gynaecology, Catalan Institute of Oncology (ICO)-Hospital Universitari Josep Trueta, 17007 - Girona/ES
  • 12 Gynaecology, Catalan Institute of Oncology (ICO Badalona), Hospital Germans Trias i Pujol, 8916 - Badalona/ES
  • 13 Oncology Data Science (odyssey) Group, Vall d'Hebron University Hospital, 08035 - Barcelona/ES
More

Resources

Abstract 4012

Background

Hallmarks of BMCOC are increased sensitivity to platinum-based CT (PCT) and PARP inhibitors (PARPi). Regulatory approvals of PARPi will affect CT strategies for heavily pretreated BMCOC pts. Effectiveness of CT in this population is investigated.

Methods

BMCOC pts who received CT from 2006-2016 at 4 cancer centers in Spain were retrospectively selected. OS and time to progression (TTP) were calculated with Kaplan Meier and Cox models.

Results

Out of 135 BMCOC pts identified (63% BRCA1; 37% BRCA2; 6 pts somatic), 87 (64%) had recurrent disease. After a median follow-up of 6 years, OS rate was 67% in BRCA1 and 66% in BRCA2 pts (p = 0.98). Median treatment lines after relapse was 4 (2-7); 42 pts (48%) were exposed to PARPi. At 3rd relapse, 78% pts remained platinum-sensitive (P-S). Out of 156 treatments given to 57 pts who had ≥3 treatment lines, 44% were PCT, 27% non-PCT, 14% PARPi and 15% PCT plus PARPi. Across all treatment lines, median TTP was 10.2 m (CI95% 8.4-11.9). In P-S context, TTP was improved with PCT plus PARPi (17.1 m), PCT (12.6 m) or PARPi (12.4 m) vs non-PCT (4.9 m, p  0.4 all comparisons). Multivariate model (BRCA1/2 status, treatment line and prior PARPi) confirmed platinum sensitivity as the strongest predictor for longer TTP beyond 2nd relapse (HR 0.28; p 

Conclusions

Heavily pretreated BMCC demonstrated increased CT sensitivity, including for non-PCT choices. In P-S setting, either PCT rechallenge (+/- PARPi) or PARPi monotherapy represent the best treatments options. PARPi exposure does not compromise benefit to subsequent CT. In this population, platinum-sensitivity remains the main prognostic factor to predict CT benefit.

Clinical trial identification

Legal entity responsible for the study

Vall d’Hebron University Hospital Institute of Oncology (VHIO)

Funding

None

Disclosure

A. Oaknin: Membership on advisory board or board of directors: Roche, Astra-Zeneca, Clovis, PharmaMar. All other authors have declared no conflicts of interest.

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