A Real World Study Of PARP Inhibitors In Ovarian Cancer

Objective: Epithelial ovarian cancer has a poor prognosis,with a cumulative recurrence rate of up to 70% after initial treatment.The development of PARP inhibitors has improved this situation.There are a large number of RCTS on PARP inhibitors at home and abroad,but there are few studies on the actual clinical application of such drugs.The purpose of this study was to evaluate the efficacy and safety of Niraparib,a class of classic PARP inhibitors,in our hospital.Methods: In this study,40 patients with ovarian cancer who received Niraparib in our hospital from March 2020 to July 2021 were included.The clinicopathologic data and follow-up data of these patients were collected,and the real-world clinical data of this study were divided into first-line maintenance treatment group and post-recurrence maintenance treatment group according to the disease conditions of the patients.The prognosis of the two groups of ovarian cancer patients in the real-world clinical data of this study was analyzed,and the related factors affecting the prognosis were analyzed by univariate analysis.Efficacy was assessed in enrolled patients using RECIST 1.1 and safety was assessed in enrolled patients using NCICTCAE 4.0.Results: 40 patients with ovarian cancer were finally selected for analysis in this study.A total of 32 patients had stable disease during Niraparib therapy(ORR82.5%),including 32 patients with CR(80.0%)and 1 patient with PR(2.5%).There were also 1 SD(2.5%)and6 PD(15%)cases.For patients who maintained treatment after relapse,six factors(pathological classification of patients,HRD status,Brca gene mutation,total course of chemotherapy,course of medication of PARP inhibitor,and whether combined with bevacizumab)had statistically significant effects on PFS in the two groups.The main AEs(any grade)in patients were anemia(52.5%),neutropenia(37.5%),and sleep disturbance(45%).Severe AEs(grades 3-4)include anemia(7.5%)and neutropenia(10%).Fifteen percent of patients stopped taking the drug because they stopped taking it temporarily or took it after active treatment.12.5% of patients had reduced drug dosage due to adverse drug reactions.Two patients were discontinued due to adverse reactions.Conclusions:1.Niraparib may be more effective in first-line maintenance therapy.2.In the maintenance treatment of ovarian cancer patients with PARP inhibitors,the pathological type of tumor,HRD status,Brca gene mutation,total number of chemotherapy,medication duration of PARP inhibitors,medication duration of PARP inhibitors,and combination of bevacizumab drugs in patients with relapse maintenance therapy were analyzed.May be an independent factor for maintaining PFS benefit in patients with recurrent ovarian cancer.3.The main adverse reactions of nilaparil were hematological symptoms,mainly characterized by anemia and neutropenia,with more severe symptoms.Overall,fewer patients were discontinued or reduced due to oral nilapalil.