奥拉帕利维持治疗进展后卵巢癌的真实世界治疗数据

Real-world treatment data after ovarian cancer progression in olaparib maintenance therapy

目的 分析奥拉帕利维持治疗进展后卵巢癌不同治疗方式的疗效。方法 回顾性分析2018年7月至2021年11月本院应用奥拉帕利进行维持治疗的84例卵巢癌患者的临床资料,评估维持治疗进展后含铂或非铂化疗方案的客观缓解率,采用Kaplan-Meier法分析两种化疗方案的中位二次进展时间(TTSP),以及奥拉帕利维持治疗进展后应用抗血管生成类药物单药或联合治疗的疗效。结果 84例患者的中位无进展生存时间为21.7个月(95%CI:15.4~28.0)。奥拉帕利维持治疗疾病进展后,21例患者接受含铂化疗,6例接受非铂化疗。含铂化疗组的中位TTSP为8.9个月(95%CI:6.8~11.1),优于非铂化疗组的2.7个月(95%CI:0~8.7)。随访12个月时,非铂化疗组患者全部进展,含铂化疗组仍有10%的患者疾病未进展。奥拉帕利维持治疗进展后,7例(17.9%)患者进行了抗血管生成类药物的单药或联合治疗;5例(71.4%)患者在治疗期间达到部分缓解,其中3例患者接受奥拉帕利联合抗血管生成类药物治疗,中位TTSP分别为7.7、7.9、9.3个月,并且其中2例患者随访结束时仍在接受治疗,且疾病未进展。结论 奥拉帕利维持治疗进展后,含铂化疗对卵巢癌仍然有效,部分患者通过含铂化疗取得了较长的生存期;抗血管生成类药物的应用可使部分患者再次获得疾病的缓解,为奥拉帕利维持治疗进展后卵巢癌的治疗带来了新的希望。

Objective To analyze the efficacy of different treatments after ovarian cancer progression in olaparib maintenance therapy.Methods In this retrospective study,the clinical data of 84 patients with ovarian cancer treated with olaparib in our hospital between July 2018 and November 2021 were included to evaluate the objective response rate of platinum or non-platinum chemotherapy after disease progression in maintenance therapy.Kaplan-Meier method was used to analyze the median time to secondary progression(TTSP) of the two chemotherapy regimens and the efficacy of antiangiogenic agents monotherapy or combination therapy after disease progression in olaparib maintenance therapy.Results The median progression-free survival of the 84 patients was 21.7 months(95% CI:15.4~28.0).After disease progression,21 patients received platinum-based chemotherapy,and 6 patients received non-platinum chemotherapy.The median TTSP of platinumbased chemotherapy group was 8.9 months(95% CI:6.8~11.1),which was significantly longer than that of non-platinum chemotherapy group(2.7 months,95% CI:0~8.7).After 12 months of follow-up,all patients in non-platinum chemotherapy group had disease progressed,but there were still 10% patients in the platinum-based chemotherapy group having no progression.After disease progression,seven patients(17.9%) received monotherapy or combination therapy,and five(71.4%) of them achieved partial response during the treatment period.Among the five patients,three received olaparib combined with antiangiogenic drugs,and their TTSP was respectively 7.7,7.9,9.3 months.Importantly,two of the three were still in treatment without progression at the end of follow-up.Conclusion After the ovarian cancer progressed in olaparib maintenance therapy,platinum-based chemotherapy was still effective,and some patients achieved a longer survival time after platinum-based chemotherapy.The application of antiangiogenic drugs can make part of the patients regain remission of the disease,bringing new hope for the treatment after ovarian cancer progression in olaparib maintenance therapy.