Effects of PARP Inhibitors on Subsequent Platinum-Based Chemotherapy in Patients with Recurrent Ovarian Cancer

Simple Summary Poly(adenosine diphosphate-ribose) polymerase inhibitors (PARP-is) play crucial roles in the treatment of ovarian cancer. However, the best therapeutic strategy for recurrence during PARP-i maintenance therapy remains unknown. The aim of this study was to elucidate the efficacy of platinum-based chemotherapy after PARP-i treatment in recurrent ovarian cancer. Eighteen patients were enrolled in the present study. The median progression-free survival (PFS) for all patients was 6.5 months, and the median overall survival (OS) was 17.6 months. The evaluation of the risk factors for PFS revealed that bevacizumab use in subsequent therapies was significantly associated with extended PFS. The median PFS was significantly longer in the chemotherapy with the bevacizumab group than in chemotherapy alone (8.9 months vs. 3.1 months, log-rank p = 0.022). The present study highlighted that platinum-based chemotherapy with bevacizumab in subsequent therapies would provide substantial benefits in the PFS of patients with recurrent ovarian cancer.Abstract The clinical outcomes in patients with ovarian cancer have been significantly improved by Poly(adenosine diphosphate-ribose) polymerase inhibitors (PARP-is). However, the best therapeutic strategy for recurrence during PARP-i maintenance therapy remains unknown. Herein, we elucidated the efficacy of platinum-based chemotherapy after PARP-i treatment in recurrent ovarian cancer. Eligible patients had experienced relapses during PARP-i maintenance therapy lasting at least 6 months and had received subsequent platinum-based chemotherapy at our institution between January 2019 and March 2024. Progression-free survival (PFS), overall survival (OS), and risk factors for PFS were evaluated. Sixty-six patients were assessed for eligibility and eighteen were enrolled. The median follow-up period was 14.5 months. The PFS and OS of all patients were 6.5 and 17.6 months, respectively. The evaluation of the risk factors for PFS revealed that age, pathological type, duration of PARP-i maintenance therapy, prior lines of chemotherapy, and PARP-i dose reduction were not significant prognostic markers. However, bevacizumab use in subsequent therapies significantly extended the PFS. The median PFS was 3.1 months in the chemotherapy-alone group and 8.9 months in the chemotherapy with bevacizumab group (log-rank p = 0.022). Platinum-based chemotherapy with bevacizumab in subsequent therapies would provide substantial benefits in the PFS of patients with recurrent ovarian cancer.