Haggstrom, LR;
Lee, YC;
Scott, CL;
Ledermann, JA;
Gourley, C;
McNeish, I;
Amant, F;
... Friedlander, ML; + view all
(2024)
764P How long is long enough? An international survey exploring practice variations on the recommended duration of maintenance therapy with PARP inhibitors in platinum sensitive recurrent ovarian cancer and long-term outcomes.
In: Powles, T, (ed.)
Annals of Oncology.
(pp. S578-S579).
Elsevier Ltd: Barcelona, Spain.
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Abstract
Background: There is no consensus on the optimal duration of PARP inhibitor (PARPi) maintenance therapy for exceptional responders with platinum sensitive recurrent ovarian cancer (PS-ROC), defined as being progression-free for 5 years (yr) or longer. The current label is to continue PARPi until progression or toxicity, however practice varies internationally. The risk of late recurrence and of late onset myelodysplastic syndrome (MDS) and acute myeloid leukaemia (AML) are unknown.// Methods: An online international survey of experts from June 2023 to April 2024, disseminated at Gynaecologic Cancer Intergroup meetings and by Chairs of Cooperative Groups to select experienced members.// Results: 178 responses were received from 25 countries, including Australia (n=27), the United Kingdom (21), The Netherlands (16), France (13), Canada (12), Italy (11), Japan (11), Spain (11) and others (53). Most clinicians (136, 76%) lacked guidelines regarding PARPi duration. For those with guidelines, recommendations varied: 1 yr (1), 2 yr (10), 3 yr (3), or indefinite (17). Recommendations also varied for those without guidelines: most (101, 56.7%) recommended ≥5 yr, and 33 (18.3%) recommended <5 yr. Of those recommending ≥5 yr, 62 (34.8%) recommended indefinite PARPi. 55 (30.9%) reported having patients who progressed after 5 yr of PARPi, and 37 (21.9%) reported late onset MDS/AML in patients on PARPi for >5 yr. Surveillance practices including the frequency of clinical reviews, blood tests and imaging varied substantially.// Conclusions: This survey highlights the diverse practice variations and disparate views on the optimal duration of maintenance therapy with PARPi in PS-ROC. The survey suggests a notable risk of late progression and MDS/AML among exceptional responders. Detailed individual patient data is needed to draw more reliable conclusions. A large international retrospective cohort study is underway to investigate long term outcomes of exceptional responders with PS-ROC. The results will help inform development of uniform practice guidelines.
| Type: | Proceedings paper |
|---|---|
| Title: | 764P How long is long enough? An international survey exploring practice variations on the recommended duration of maintenance therapy with PARP inhibitors in platinum sensitive recurrent ovarian cancer and long-term outcomes |
| Event: | ESMO Congress 2024 |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1016/j.annonc.2024.08.825 |
| Publisher version: | https://doi.org/10.1016/j.annonc.2024.08.825 |
| Language: | English |
| Additional information: | This version is the author-accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Cancer Institute UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Cancer Institute > Research Department of Oncology |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10207303 |
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