237P - PARP inhibitor in platinum resistant ovarian cancer: Single center real world experience

Background

There is paucity of data of role of PARP inhibitors (PARPi) in BRCA mutation (gBRCAm) positive platinum resistant ovarian cancer (OC) disease. We report here analysis of outcome of PARPi treatment in patients including those with platinum resistant disease.

Methods

In this study, we analyzed efficacy of PARPi in all consecutive patients of OC with gBRCAm who received the drug. The drug was procured through compassionate program.

Results

Between July 1, 2015 and June 30, 2019, 28 patients received PARPi. At the time of data censoring (June 30, 2019), 6 (21.4%) patients are still on treatment. 5 patient received Talazoparib and 23 Olaparib. Median age is 54.5 years (range 39-75). BRCAm 1 positive patients were 20. Median number of previous lines of chemotherapy received were 3 (range 1-6). 7 platinum sensitive patients received the drug as maintenance (3 in complete response [CR] and 4 in partial response [PR]) while 21 had platinum resistant progressive disease. Overall response rate (ORR) was 82% with CR as the best response in 5 which also includes 3 patients who received the drug while in CR and maintained it. With the median treatment duration (mTD) of 14.14 months (95%CI 8.43-23.33), 71.4 % patients eventually progressed. The median follow up was 15.3 months (range 4- 42.6 months). The median overall survival (OS) was 32.9 months (95% CI 13.03 NR) The below table describes results of 21 platinum resistant patients. With the mTD of 10.4 months (95%CI 8.17 23.33), 86 % patients had progressed. Three (14%) platinum resistant patients are still on treatment with the treatment duration (TD) of 5.47, 32.9 and 37 months.

Table: 237P

Progression free survival was not calculated as disease assessment was not done at defined time point. The TD was taken as the surrogate marker for efficacy. Grade ≥3 side effects were documented in 33% patients (anemia 23.5%, thrombocytopenia 17.6%, fatigue 25%).

Conclusions

This study suggests that PARPi is a viable treatment option in patients of platinum resistant OC with gBRCAm. This should be further evaluated in randomized clinical controlled trial.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

Amit Agarwal.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.