Analysis of olaparib efficacy in patients with serous ovarian cancer

Abstract

Modern treatment of ovarian cancer is impossible without understanding the carcinogenesis and the structure of malignant epithelial ovarian tumors and carrying out molecular genetic testing for homologous recombination deficiency. The choice of maintenance therapy depends on the presence of a mutation in the BRCA1/2 genes and the HRD status of the tumor. Targeted drugs, such as bevacizumab and olaparib, are used in the treatment of ovarian cancer. The aim of the work is to determine the effectiveness of olaparib in first-line maintenance therapy and in the treatment of platinum-sensitive recurrence of ovarian cancer. A retrospective study included 67 patients with high-grade serous ovarian cancer stages I–IV who were prescribed olaparib in first-line maintenance therapy or in maintenance therapy for the treatment of disease progression, provided a complete or partial response to platinum-containing chemotherapy in the period from 2016 to 2022. The median life expectancy of the patients receiving first-line maintenance treatment coincides with the median time to progression; only one patient died due to the progression of the disease, and the rest are alive. The median time to progression in the group of patients with maintenance therapy of relapses was 23.0 ± 1.5 months, and the median life expectancy was 24.7 ± 2.3 months. When comparing the patients of the first group, depending on the term of surgical treatment performed, the median life expectancy was statistically higher with primary cytoreduction and constituted 46.0 months, while in the interval cytoreduction group, it was 25.0 months (p = 0.018). When comparing the patients of the second group, depending on the mutation in the BRCA1 and BRCA2 genes, the median life expectancy was statistically higher in the patients with a mutation in the BRCA2 gene — by 38.6 months (p = 0.020). The addition of olaparib to the treatment of BRCA-associated ovarian cancer in first-line maintenance therapy and in the treatment of platinum-sensitive relapses of the disease makes it possible to increase the median time to progression and median life expectancy.