528MO - Is re-introduction or continuation of PARP inhibitors after local therapy for oligo-metastatic progression in patients with relapsed ovarian cancer relevant?

Background

PARP inhibitors (PARPi) have revolutionized the management of High-grade epithelial ovarian cancer (HGEOC) treatment. However, a significant number of patients relapse or progress under PARPi leading to the introduction of a new line of systemic therapy as chemotherapy. In patient with a limited number of metastatic sites in progression, -referred to as the oligo metastatic progression- a potential indication for local therapy followed by re introduction or continuation of PARPi treatment rather than initiating a new line of chemotherapy could be proposed. However, the impact of local treatment on progression free survival (PFS) in these patients remains unknown.

Methods

This international multicenter retrospective study evaluated the efficacy of PARPi continuation or reintroduction in patients with HGEOC after local treatment for oligometastatic progression. The main objective was to assess PFS under PARPi after local therapy (PFS post-LT). Secondary objectives included safety and OS.

Results

74 patients were identified in 20 centers between 04/20 and 11/21. 65% of patients were BRCA mutated and 92% had received ≥ 2 lines of prior systemic chemotherapy before the initial introduction of PARPi. Main progression sites were lymph nodes (42%), peritoneum (20%), liver (11%), other visceral (9%) and other (18%). Local therapy included radiotherapy (44%), surgery (43%), both (7%), cryotherapy or radiofrequency (3%) and other (3%). Median PFS post-LT was 11.5 months [95% CI 7.4; 17.2]. After median follow up of 14.8 months, 5 patients (6.8%) discontinued PARPi due to toxicity. The 1-year overall survival rate was 90.7% [95% CI 79.1; 96.0].

Conclusions

With close to one year without progression or introduction new line of systemic therapy, this study reports the feasibility and potential benefit of this original strategy in patients with oligometastatic progression under PARPi.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

Centre Léon Bérard.

Funding

Has not received any funding.

Disclosure

M. Kfoury: Financial Interests, Personal, Invited Speaker: AstraZeneca, GSK. D. Lorusso: Financial Interests, Personal, Advisory Board, Participation in Advisory Boards and Invited Speaker: GSK, Clovis Oncology, PharmaMar; Financial Interests, Personal, Advisory Board, Participation in Advisory Boards and Invited Speakers: AstraZeneca, MSD; Financial Interests, Personal, Other, Consultancy: PharmaMar, Amgen, AstraZeneca, Clovis Oncology, GSK, MSD, Immunogen, Genmab, Seagen; Financial Interests, Personal, Advisory Board, Participation in Advisory Boards: Merck Serono; Financial Interests, Personal, Advisory Board, Invited member of advisory board: Seagen, Immunogen, Genmab, Oncoinvest, Corcept, Sutro; Financial Interests, Institutional, Funding, Grant for founding accdemic trial: MSD, Clovis Oncology, PharmaMar; Financial Interests, Institutional, Funding, Grant for founding acamemic trial: GSK; Financial Interests, Institutional, Invited Speaker, ENGOT trial with institutional support for coordination: Clovis Oncology; Financial Interests, Institutional, Invited Speaker, ENGOT trial with insitutional support for coordination: Genmab, MSD; Financial Interests, Institutional, Funding, Clnical trial/contracted research: AstraZeneca, Clovis Oncology, GSK, MSD, Seagen; Financial Interests, Institutional, Funding, Clinical trials/contracted research: Genmab, Immunogen, Incyte, Novartis, Roche; Non-Financial Interests, Principal Investigator, PI of several trials, no compensation received: GSK; Non-Financial Interests, Principal Investigator, PI of several trials. No personal compensation received: AstraZeneca, Genmab; Non-Financial Interests, Principal Investigator, PI in several trials. No personal compensation received: MSD; Non-Financial Interests, Principal Investigator, PI of clinical trial. No personal compensation received: immunogen, clovis, Incyte; Non-Financial Interests, Principal Investigator, PI of clinical trial. No personal compensation receive: Roche; Non-Financial Interests, Member, Board of Directors: GCIG. A. Floquet: Financial Interests, Personal, Invited Speaker: AstraZeneca, Clovis Oncology, GSK, PharmaMar. L. Polastro: Financial Interests, Personal, Advisory Board: Advisory AstraZeneca. B. You: Financial Interests, Personal, Advisory Board: MSD, Astra-Zeneca, GSK-Tesaro, Bayer, Roche-Genentech, ECS Progastrine, Novartis, LEK, Amgen, Clovis Oncology, Merck Serono, BMS, Seagen, Myriad. T. De La Motte Rouge: Financial Interests, Personal, Advisory Board: Pfizer, AstraZeneca, GSK, Clovis Oncology, Roche, Mylan, Tesaro; Financial Interests, Institutional, Advisory Board: MSD; Financial Interests, Institutional, Research Grant: Novartis, Pfizer, Msd, Seagen; Financial Interests, Institutional, Invited Speaker: Roche, Astrazeneca, Gsk, Msd, Pfizer, Netris Pharma; Non-Financial Interests, Advisory Role: French National Cancer Institute, Unicancer; Non-Financial Interests, Principal Investigator: ARCAGY. I.L. Ray-Coquard: Financial Interests, Personal, Advisory Board: Roche, GSK, AstraZeneca, Mersana, Deciphera, Amgen, Oxnea, Merck Sereno, Agenus, Novartis, Macrogenics, Clovis; Financial Interests, Institutional, Other, COLIBRI translational research: BMS; Financial Interests, Institutional, Advisory Board, translational research NEOPREMBROV trial: MSD; Non-Financial Interests, Principal Investigator: PAOLA1. All other authors have declared no conflicts of interest.