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Background <p>To evaluate the efficacy of platinum-based chemotherapy in platinum-sensitive recurrent ovarian cancer (PSROC) between patients with and without prior exposure to poly(ADP-ribose) polymerase inhibitor (PARPi).</p> Methods <p>Patients with PSROC treated at Jichi Medical University Hospital between January 2010 and December 2024 were retrospectively reviewed. Post-PARPi and PARPi-naïve patients were extracted from 2018 to 2024 (post-market of PARPi) and 2010 to 2017 (pre-market of PARPi), respectively, and subjected to 1:1 propensity score matching. The response rate, progression-free survival (PFS), and overall survival (OS) were analyzed.</p> Results <p>The matched cohort included 22 patients in each group. After matching, the objective response rate was lower in the post-PARPi group than in the PARPi-naïve group (59.1% vs. 86.4%), although the difference was not statistically significant (<i>p</i> = 0.088). Before matching, both PFS (7.1 vs. 12.0&#xa0;months, <i>p</i> = 0.005) and OS (22.1 vs. 43.8&#xa0;months, <i>p</i> = 0.001) were significantly shorter in the post-PARPi group. After matching, PFS (7.0 vs. 12.4&#xa0;months, <i>p</i> = 0.069) and OS (15.4 vs. 33.6&#xa0;months, <i>p</i> = 0.091) remained numerically shorter. On multivariate analysis, response at prior PARPi initiation (partial vs. complete response) and the status of PARPi use at recurrence (on PARPi vs. after PARPi therapy) were independent predictors for PFS among post-PARPi patients, whereas the platinum-free interval did not independently predict prognosis.</p> Conclusions <p>Prior PARPi exposure, particularly partial response to platinum at the start of prior PARPi therapy and recurrence on PARPi therapy, may be associated with reduced platinum efficacy and worse prognosis in PSROC.</p>

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Impact of prior PARP inhibitor exposure on the efficacy of platinum-based chemotherapy in platinum-sensitive recurrent ovarian cancer: a propensity score-matched analysis

  • 期刊论文

  • 发表日期：

    2026年3月26日

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  • Yoshifumi Takahashi,
  • Miku Takadera,
  • Seung Chik Jwa,
  • Takahiro Koyanagi,
  • Yasushi Saga,
  • Yuji Takei,
  • Hiroyuki Fujiwara

摘要

Background

To evaluate the efficacy of platinum-based chemotherapy in platinum-sensitive recurrent ovarian cancer (PSROC) between patients with and without prior exposure to poly(ADP-ribose) polymerase inhibitor (PARPi).

Methods

Patients with PSROC treated at Jichi Medical University Hospital between January 2010 and December 2024 were retrospectively reviewed. Post-PARPi and PARPi-naïve patients were extracted from 2018 to 2024 (post-market of PARPi) and 2010 to 2017 (pre-market of PARPi), respectively, and subjected to 1:1 propensity score matching. The response rate, progression-free survival (PFS), and overall survival (OS) were analyzed.

Results

The matched cohort included 22 patients in each group. After matching, the objective response rate was lower in the post-PARPi group than in the PARPi-naïve group (59.1% vs. 86.4%), although the difference was not statistically significant (p = 0.088). Before matching, both PFS (7.1 vs. 12.0 months, p = 0.005) and OS (22.1 vs. 43.8 months, p = 0.001) were significantly shorter in the post-PARPi group. After matching, PFS (7.0 vs. 12.4 months, p = 0.069) and OS (15.4 vs. 33.6 months, p = 0.091) remained numerically shorter. On multivariate analysis, response at prior PARPi initiation (partial vs. complete response) and the status of PARPi use at recurrence (on PARPi vs. after PARPi therapy) were independent predictors for PFS among post-PARPi patients, whereas the platinum-free interval did not independently predict prognosis.

Conclusions

Prior PARPi exposure, particularly partial response to platinum at the start of prior PARPi therapy and recurrence on PARPi therapy, may be associated with reduced platinum efficacy and worse prognosis in PSROC.