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Objective <p>This analysis aimed to characterize exceptional responder with long-term PARP inhibitor therapy (ExR-LT) in platinum-sensitive recurrent ovarian cancer.</p> Methods <p>This analysis included ExR-LT. ExR-LTs are defined as patients that received a continuous maintenance therapy for recurrent ovarian cancer with olaparib or niraparib for at least 5&#xa0;years and showed an exceptional response. Exceptional response was defined as progression-free survival (PFS) of at least 5&#xa0;years. This analysis has a retrospective and descriptive character.</p> Results <p>23 patients were included. The median duration of PARPi therapy was 7.1&#xa0;years (range 5.3; 10.5). The longest treatment duration was reached in the BRCA1 mutation (BRCA1m) cohort with a mean duration of 8&#xa0;years (range 5.3; 10.5&#xa0;years). The majority of patients (16 patients, 69.7%) reported adverse events (AE) during PARPi therapy. 12 patients (52.2%) had mild AE (CTCAE 1 or 2), 4 patients (17.4%) reported more severe AE (CTCAE 3). 14 patients needed a dose reduction due to treatment-related AE (60.1%). The most common indications for dose reduction were anemia (17.4%), headache and limb pain (17.4%), and fatigue (13%). Four patients (17.4%) required an interruption of PARPi therapy. Ten patients received a dose reduction within the first 6&#xa0;months and two patients after one and 1.3&#xa0;years of PARPi therapy. No dose adjustments were necessary between 1.5 and 4&#xa0;years. After 4&#xa0;years, 3 patients (13%) received a late dose reduction. 8.6% had another cancer diagnosed before, 4.3% simultaneously, and 13% after the ovarian cancer diagnosis.</p> Conclusion <p>ExR-LTs present with heterogenic clinical and genetic characteristics. Clinical management is complex because of a high rate of AE and need of dose reductions at various points in time. Close monitoring for AE, recurrences and secondary malignancies must be carried out throughout the entire time of treatment.</p>

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Characterization of exceptional responders with long-term PARP inhibitor therapy in recurrent ovarian cancer: an analysis of 23 patients from Charité

  • 期刊论文

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  • 发表日期：

    2026年2月26日

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  • Jacek Glajzer,
  • Jalid Sehouli,
  • Hannah Woopen,
  • Elena Ioana Braicu,
  • Joanna Baum,
  • Jacek P. Grabowski

摘要

Objective

This analysis aimed to characterize exceptional responder with long-term PARP inhibitor therapy (ExR-LT) in platinum-sensitive recurrent ovarian cancer.

Methods

This analysis included ExR-LT. ExR-LTs are defined as patients that received a continuous maintenance therapy for recurrent ovarian cancer with olaparib or niraparib for at least 5 years and showed an exceptional response. Exceptional response was defined as progression-free survival (PFS) of at least 5 years. This analysis has a retrospective and descriptive character.

Results

23 patients were included. The median duration of PARPi therapy was 7.1 years (range 5.3; 10.5). The longest treatment duration was reached in the BRCA1 mutation (BRCA1m) cohort with a mean duration of 8 years (range 5.3; 10.5 years). The majority of patients (16 patients, 69.7%) reported adverse events (AE) during PARPi therapy. 12 patients (52.2%) had mild AE (CTCAE 1 or 2), 4 patients (17.4%) reported more severe AE (CTCAE 3). 14 patients needed a dose reduction due to treatment-related AE (60.1%). The most common indications for dose reduction were anemia (17.4%), headache and limb pain (17.4%), and fatigue (13%). Four patients (17.4%) required an interruption of PARPi therapy. Ten patients received a dose reduction within the first 6 months and two patients after one and 1.3 years of PARPi therapy. No dose adjustments were necessary between 1.5 and 4 years. After 4 years, 3 patients (13%) received a late dose reduction. 8.6% had another cancer diagnosed before, 4.3% simultaneously, and 13% after the ovarian cancer diagnosis.

Conclusion

ExR-LTs present with heterogenic clinical and genetic characteristics. Clinical management is complex because of a high rate of AE and need of dose reductions at various points in time. Close monitoring for AE, recurrences and secondary malignancies must be carried out throughout the entire time of treatment.