| Objective(s):1.This study was based on retrospective data to analyze the efficacy and related factors of Poly ADP-ribose Polymerase(PARP)inhibitors in maintenance therapy of ovarian cancer patients.2.To obtain the Homologous Recombination Deficiency(HRD)score of ovarian cancer patients and explore its clinical significance in the maintenance treatment of PARP inhibitors in ovarian cancer.Methods:According to the inclusion and exclusion criteria,the informed consent was signed,and the patients who achieved Complete Response(CR)or Partial Response(Partial Response,CR)after platinum-based treatment in our hospital from 2018 to2022 were collected.The data of 84 patients with ovarian cancer who received PARP inhibitor maintenance therapy were collected.The factors that may affect the efficacy of PARP inhibitor(such as pathological type,pathological stage,surgical satisfaction,etc.)were analyzed comprehensively.The efficacy data of patients were collected and correlated with the HRD score to explore the predictive effect of different score intervals on the efficacy.The correlation analysis between the factors affecting the efficacy of PARP inhibitors combined with HRD score and efficacy data was performed to explore its predictive effect on PARP inhibitors..Results:The 84 patients in this study were divided into group 1(using Myriad my Choice CDx)and group 2(using Amoy Dx)according to different HRD scoring standards.1.Among the 50 ovarian cancer patients in group 1,the average Quality Of Life(QOL)scores of patients who continued to use PAPR inhibitors and those who discontinued PAPR inhibitors(due to disease progression or death)were 53.35±8.73 and 45.09±13.61,respectively.There was no significant difference in the HRD score between patients who continued and discontinued PARP inhibitors(P>0.05).The HRD scores of patients who continued and discontinued PAPR inhibitors were 64.9±21.41 and 59.72±18.05,respectively.There was no significant difference between the two groups(P>0.05).In group 1,the mean HRD values in patients receiving olaparib and niraparib were 64.76 ± 18.04 and 60.5± 56.34,respectively,with no statistically significant difference(P>0.05).The mean value of QOL was 50.27±11.81 and 53.50±6.87,respectively(P>0.05).In group 1,the positive rate of Breast Cancer Susceptibility Gene(BRAC)in patients who continued and discontinued PARP inhibitors was 90.9% and 9.1%,respectively.The rate of BRAC negativity in patients who continued and discontinued PARP inhibitors was 55% and 45%,respectively(P=0.008).In group 2,the positive rate of BRAC in patients who continued and discontinued PARP inhibitors was 8.3% and 91.7%,respectively,and the negative rate of BRAC in patients who continued and discontinued PARP inhibitors was 63.6% and36.4%,respectively,and the difference was not statistically significant(P>0.05).2.The median Progression-Free Survival(PFS)of patients treated with olaparib in group 1 was not reached,and the 10-month PFS rate was 86.7%.The median PFS of patients treated with niraparib was 17 months(95%CI 9.6-16.6).The PFS of patients treated with olaparib was significantly better than that of niraparib,and the difference in PFS between the two groups was statistically significant(P=0.031).In group 2,the median PFS of patients treated with olaparib was not reached,and the 10-month PFS rate was 91.2%.The median PFS of patients treated with niraparib was 9 months(95%CI 7.4-10.7),and there was no statistically significant difference in PFS between the two groups(P>0.05).Among all patients(n = 84),the median PFS of patients treated with olaparib was not reached,and the 10-month PFS rate was 88.1%.The median PFS of patients treated with niraparib was 12 months(95%CI 9.7-14.2),and the PFS of patients treated with olaparib was significantly better than that of niraparib in all patients(P=0.001).3.In group 1,the median PFS of BRAC positive patients was not reached,and the10-month PFS rate was 95.4%.The median PFS of BRAC negative patients was 17months(95%CI 10.1-16.9),and the PFS of BRAC positive patients was significantly better than that of BRAC negative patients(P=0.002).In group 2,the median PFS of BRAC positive patients was not reached,and the 10-month PFS rate was 91.7%.The median PFS of BRAC negative patients was 9 months(95%CI 7.4-10.7),and there was no significant difference in PFS between the two groups(P>0.05).The median PFS of the 84 patients with BRAC positive was not reached,and the 10-month PFS rate was 94.1%.The median PFS of BRAC negative patients was 17 months(95%CI10.7-15.2).The PFS of BRAC positive patients was significantly better than that of BRAC negative patients,and the difference in PFS between the two groups was statistically significant(P<0.001).4.In group 1,the median PFS of HRD-positive patients was not reached,and the10-month PFS rate was 80%.The median PFS of HRD-negative patients was 14months(95%CI 9.3-19.1),and the PFS of HRD-positive patients was significantly better than that of HRD-negative patients,and the difference was statistically significant(P=0.006).In group 2,the median PFS of HRD-positive patients was 12months(95%CI 8.5-11.4),and that of HRD-negative patients was 7 months(95%CI4.9-7.9).There was no significant difference in PFS between the two groups(P>0.05).5.In group 1,the median PFS of patients with HRD score ≥30 was not reached,and the 10-month PFS rate was 80%.The median PFS of patients with HRD<30 was 7months.In group 1,the PFS of patients with HRD≥30 was significantly better than that of patients with HRD<30,and the difference was statistically significant(P=0.009).In group 1,the median PFS of patients with HRD score ≥60 was not reached,and the 10-month PFS rate was 92%.The median PFS of patients with HRD<60 was 7 months.In group 1,the PFS of patients with HRD≥60 was significantly better than that of patients with HRD<60,and the difference between the two groups was statistically significant(P=0.001).After excluding the samples with HRD score <42 in group 1,the median PFS of patients with HRD score ≥60 was not reached,and the 10-month PFS rate was92%.The median PFS of patients with HRD<60 was not reached,and the 10-month PFS rate was 58.3%.After excluding the samples with HRD score <42 in group 1,the PFS of patients with HRD≥60 was significantly better than that of patients with HRD<60,and the difference was statistically significant(P=0.019).6.Among all patients,the median PFS of patients with FIGO stage II was 9months.The median PFS of patients with FIGO stage III was not reached,and the 10-month PFS rate was 78.4%.The median PFS of patients with FIGO stage IV was not reached,and the 10-month PFS rate was 81%.The P value of three stages was 0.892(P>0.05),which was not statistically significant.7.Among all patients,high-grade serous carcinoma and non-high-grade serous carcinoma according to pathological type,the median PFS of high-grade serous carcinoma was not reached,and the 10-month PFS rate was 78.8%.The median PFS of high-grade serous carcinoma was not reached,and the 10-month PFS rate was78.8%.There was no significant difference in PFS between the two groups(P>0.05).8.In multivariate analysis,the results of PFS showed that in group 1,HRD<30and HRD ≥ 30 had no statistically significant effect on PFS(HR=0.4,95%CI 0.11-1.5,P=0.175);Olaparib and niraparib had no significant effect on PFS(HR=1.35,95%CI 0.34-5.26,P=0.662).BRAC positive and negative had a statistically significant effect on PFS(HR=8.25,95%CI 1.46-46.5,P=0.017).9.In multivariate analysis,the results of PFS showed that patients with HRD<60points and patients with HRD≥60 points in group 1 had a statistically significant effect on PFS(HR=0.26,95%CI 0.71-0.95,P=0.042);Olaparib and niraparib had no significant effect on PFS(HR=1.57,95%CI 0.39-6.4,P=0.528).BRAC positive and negative had a statistically significant effect on PFS(HR=6.98,95%CI 1.15-42.5,P=0.035).10.In the multivariate analysis,the results of PFS showed that the effect of HRD<60 and HRD≥60 on PFS was not statistically significant(HR=0.3,95%CI 0.72-1.25,P=0.99)after excluding the samples with HRD<42 in group 1.Olaparib and niraparib had no significant effect on PFS(HR=1.5,95%CI 0.33-6.82,P>0.05).BRAC positive and negative had a statistically significant effect on PFS(HR=11.9,95%CI1.15-122.8,P=0.038).Conclusion(s):1.In ovarian cancer patients treated with PARP inhibitors in maintenance therapy,the PFS of patients with HRD score ≥60 was significantly better than that of patients with HRD score <60 in patients with HRD score ≥42(HRD positive)according to Myr iad my Choice CDx score.HRD score ≥60 can be used to further evaluate the efficacy of PARP inhibitors.2.In ovarian cancer patients treated with PARP inhibitors in maintenance therapy,the PFS of patients with HRD score ≥30 using Myriad my Choice CDx score was signif icantly better than that of patients with HRD score <30.3.In ovarian cancer patients treated with PARP inhibitors in maintenance therapy,BRAC positive patients had significantly better PFS than BRAC negative patients.4.In ovarian cancer patients treated with PARP inhibitors in maintenance therapy,HRD-positive patients using the Myriad my Choice CDx score had significantly better PFS than HRD-negative patients.5.In ovarian cancer patients treated with PARP inhibitors as maintenance therapy,PFS was significantly better with olaparib than with niraparib.6.In ovarian cancer patients treated with PARP inhibitors as maintenance therapy,olaparib or niraparib had no effect on QOL score. |
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