Abstract 744P
Background
Bevacizumab (bev) in advanced ovarian cancer is associated with improved outcome. Maintenance therapy with PARPi is associated with improvement in survival especially in the cohort who have a BRCA mutation. The goal of this analysis of a real-world database was to look at the clinical utilization and prognostic impact of bev and PARPi among pts with advanced ovarian cancer.
Methods
We utilized a federated network of de-identified health data representing approximately 64 million pt lives available through the TriNetX Platform. We identified 2877pts diagnosed with stage III/IV ovarian cancer diagnosed between 2015 and 2020 who received bev/PARPi in the 1st year of diagnosis. Overall survival (OS) was computed using the Kaplan Meier product limit method. Propensity score matching was performed on all comparisons of OS. Matching variables included age, timing of ovarian cancer diagnosis (late vs early), presence and site of secondary metastases, type and number of lines of therapy and type of surgery.
Results
619 pts, 2,115pts, and 143pts used PARPi alone, bev alone, or PARPi + bev in the 1st yr of diagnosis. 2-year OS was 62.7% and 59.5% among pts who did and did not receive PARPi respectively (p=0.003). No difference in OS was observed comparing olaparib to niraparib (p=0.79) or rucaparib (p=0.23) respectively. 2-year OS was 54.1% and 63.3% among pts who received PARPi + bev and PARPi alone respectively (HR 1.72, 95% CI 1.08-2.72, p=0.021). 2-year OS was 67.1% and 60.5% among pts who received PARPi alone and bev alone respectively (HR 0.63, 95% CI 0.50-0.80, p<0.0001). Pts who were and were not re challenged with a PARPi had similar odds of being deceased (OR 1.14, 95% CI 0.84-1.54). 1,304 pts of white race and 101 pts of black race received PARPi with higher uptake observed among white pts compared to black pts with differences increasing over time. In 2020 rate of uptake was 92 per 1000 and 139 per 1000 among pts of black and white race respectively. 2-year OS was 63.32% and 53.64% among pts of white and black race respectively (HR 2.06, 95% CI 0.62- 1.80, p=0.82).
Conclusions
In line with clinical trial results we show that use of PARPi in the 1st year of diagnosis improves outcome of pts with stage III/IV ovarian cancer with no differences observed among the three available PARPi.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
TriNetX, Llc.
Funding
Has not received any funding.
Disclosure
S. Dawood: Financial Interests, Personal, Advisory Board: Roche; Financial Interests, Personal, Invited Speaker: Roche; Financial Interests, Personal, Invited Speaker: MSD; Financial Interests, Personal, Invited Speaker: BMS; Financial Interests, Personal, Invited Speaker: Pfizer; Financial Interests, Personal, Invited Speaker: Lilly; Financial Interests, Personal, Invited Speaker: AstraZeneca; Financial Interests, Personal, Advisory Board: AstraZeneca; Financial Interests, Personal, Advisory Board: Lilly; Financial Interests, Institutional, Research Grant: MSD; Non-Financial Interests, Member: ASCO. K. Brzozowski: Financial Interests, Personal, Full or part-time Employment: TriNetX, Llc.