Precision Q, Integra Connect, West Palm Beach, FL
Anupama Vasudevan , Sandy English , Mike Gart , Taofikat Oladipo , John Hartman , Laura L. Iadeluca , Fred J. Kudrik
Background: Niraparib and bevacizumab are the only FDA-approved first-line maintenance (1LM) therapies for advanced ovarian cancer (AOC) without a biomarker requirement. However, little information exists regarding the effectiveness of these treatments in the real world. Methods: We identified 89 AOC patients from the US-based deidentified Integra PrecisionQ database who received 1LM bevacizumab (n=31) or niraparib (n=58) following induction chemotherapy (CT) ± bevacizumab initiated between July 1, 2019, and March 31, 2021, and followed them until the data cut-off of March 31, 2022. Using the start of maintenance therapy as the index date, we examined patient characteristics, time to next treatment or death (TTNT; often used as a real-world proxy for progression-free survival), and overall survival (OS) for these treatment groups. Results: For patients who received 1LM bevacizumab, the median age was 69 years, 65% had Stage III cancer at index date, 84% had Eastern Cooperative Oncology Group (ECOG) performance status 0–1, and 87% received CT + bevacizumab as first-line therapy. For patients who received 1LM niraparib, the median age was 68.5 years, 66% had Stage III cancer at index date, 88% had an ECOG performance status of 0–1, and 79% received chemotherapy alone as first-line therapy. Only 1 bevacizumab (BRCAm) and 11 niraparib (4 BRCAm, 7 BRCAwt HRd) patients had known homologous recombination deficiency (HRd)-positive tumors. Patients treated with bevacizumab had a median TTNT of 4.5 months (mo) and a 12-month OS mark of 83.6%; for patients treated with niraparib, the corresponding values were 9.9 mo and 96.3%. Conclusions: Our study provides real-world outcomes data for newly diagnosed AOC patients receiving maintenance niraparib or bevacizumab following CT +/- bevacizumab. HRd testing results were only available for 19% of bevacizumab- and 40% of niraparib-treated patients, highlighting a need for greater testing in the real world. Future studies should examine which patient characteristics are associated with long-term survival for these and other treatment options to aid in the decision-making process. Funding: GSK215281.
Bevacizumab (n=31) | Niraparib (n=58) | |
---|---|---|
BRCAm, n (%) | 1 (3.2) | 4 (6.9) |
BRCAwt HRd, n (%) | 0 (0) | 7 (12.1) |
BRCAwt HRp, n (%) | 5 (16.1) | 12 (20.7) |
BRCAwt HR unknown, n(%) | 17 (54.8) | 24 (41.4) |
BRCA and HR unknown, n (%) | 8 (25.8) | 11 (19.0) |
Median TTNT, months* | 4.5 (2.5, 9.6) | 9.9 (7.8, 13.5) |
12-Month TTNT rate, %* | 20.2 (8.2, 35.9) | 43.6 (29.6, 56.9) |
Median OS, months* | NR (16.5, NR) | NR (23.7, NR) |
12-Month OS rate, %* | 83.6 (65, 92.8) | 96.3 (85.8, 99.1) |
*95% confidence intervals in parentheses. HR, homologous recombination; HRd, HR deficiency; HRp, HR proficiency; NR, not reached. Note that this is a non-comparative study.
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Abstract Disclosures
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