Comparative characteristics of the effectiveness of therapy with PARP inhibitor in patients with primary ovarian cancer in the Tyumen Region in the period from 2019 to 2023

Background. Malignant neoplasms of the ovaries are the fifth leading cause of death in women in the United States and the eighth in the world. Over the past ten years, both in Russia and in the Tyumen Region, there has been a gradual increase in the incidence of ovarian cancer: the average annual growth rate of standardized incidence rates from 2012 to 2022 in the Russian Federation was 0.03 %, and the overall increase was –2.52 %. Hereditary predisposition associated with the presence of a mutation in the BRCA1/2 genes plays a major role in the occurrence of this malignant disease.

Aim. To evaluate the efficacy and tolerability of maintenance therapy with a PARP inhibitor in patients with high-grade serous and endometrioid ovarian cancer in the Tyumen Region from 2019 to 2023.

Materials and methods. A retrospective statistical analysis of the overall incidence of ovarian malignancies, assessment of 5-year overall survival and progression-free survival in patients receiving a PARP inhibitor and previous platinumbased polychemotherapy was performed.

Results. The total group of examined patients included 79 women, of whom PARP inhibitor as maintenance therapy for primary ovarian cancer was prescribed to 36 observed patients, a separate placebo group was allocated – 27 patients who did not receive targeted therapy after platinum-containing polychemotherapy regimens. In the course of the work, it was found that the use of PARP inhibitor demonstrates better results both in terms of 5-year overall survival (absolute gain was 11.6 %) and progression-free survival (absolute gain – 35.6 %).

Conclusion. Regardless of the volume of cytoreduction and previous treatment regimens, disease progression against the background of taking a PARP inhibitor was observed significantly less frequently than in patients who did not receive targeted therapy: 33.3 % versus 58.6 %.

1. Siegel R.L., Giaquinto A.N., Jemal A. Cancer statistics, 2024. CA Cancer J Clin 2024;74(1):12–49. DOI: 10.3322/caac.21820

2. Phung M.T., Pearce C.L., Meza R., Jeon J. Trends of ovarian cancer incidence by histotype and race/ethnicity in the United States 1992–2019. Cancer Res Commun 2023;3(1):1–8. DOI: 10.1158/2767-9764.crc-22-0410

3. Webb P.M., Jordan S.J. Epidemiology of epithelial ovarian cancer. Best Pract Res Clin Obstet Gynaecol 2017;41:3–14. DOI: 10.1016/j.bpobgyn.2016.08.006

4. Cabasag C.J., Fagan P.J., Ferlay J. et al. Ovarian cancer today and tomorrow: A global assessment by world region and Human Development Index using GLOBOCAN 2020. Int J Cancer 2022;151(9):1535–41. DOI: 10.1002/ijc.34002

5. Malignant tumors in Russia in 2022 (incidence and mortality). Ed. by A.D. Kaprin et al. Moscow: MNIOI im. P.A. Hertsena – filial FGBU “NMITS radiologii” Minzdrava Rossii, 2023. 275 p. (In Russ.)

6. Pavlova V.I., Busarova E.S., Gaysin T.R. et al. On the state of cancer care in the Tyumen region for 2023: information bulletin. Tyumen, 2024. 62 p. (In Russ.).

7. Tikhomirova T.E., Tyulyandina A.S., Rumyantsev A.A. et al. BRCA-associated ovarian cancer: a review of the current literature. Tazovaya khirurgiya i onkologiya = Pelvic Surgery and Oncology 2022;12(3):56–62. (In Russ.). DOI: 10.17650/2686-9594-2022-12-3-56-62

8. Yoshida R. Hereditary breast and ovarian cancer (HBOC): review of its molecular characteristics, screening, treatment, and prognosis. Breast Cancer 2021;28(6):1167–1180. DOI: 10.1007/s12282-020-01148-2

9. Artamonova E.V., Kovalenko E.I., Snegovoy A.V. et al. Olaparib in the maintenance treatment of platinum-sensitive relapse of BRCA mutant ovarian cancer in routine clinical practice: first results of observational study in Russian patients. Sovremennaya onkologiya = Journal of Modern Oncology 2018;20(3):19–25. (In Russ.). DOI: 10.26442/1815-1434_2018.3.19-25

10. Moore K., Colombo N., Scambia G. et al. Maintenance olaparib in patients with newly diagnosed advanced ovarian cancer. N Engl J Med 2018;379:2495–505. DOI: 10.1056/NEJMoa1810858

11. Ray-Coquard I., Pautier P., Pignata S. et al. Olaparib plus bevacizumab as first-line maintenance in ovarian cancer. N Engl J Med 2019;381:2416–28. DOI: 10.1056/NEJMoa1911361

12.