Platinum-Based Chemotherapy Versus Secondary Cytoreductive Surgery Before Olaparib Maintenance Therapy for 259 Patients with BRCA Mutated Platinum-Sensitive Recurrent Ovarian Cancer: A Multicenter Retrospective Study: Comparative Effectiveness and Survival Outcomes Analysis
The benefit of secondary cytoreduction surgery (SeCRS) followed by olaparib maintenance therapy for recurrent ovarian cancer has not been clearly demonstrated. This study aimed to evaluate the role of SeCRS combined with olaparib for patients with BRCA-mutated platinum-sensitive recurrent ovarian cancer. This multi-center retrospective study analyzed patients with BRCA-mutated platinum-sensitive recurrent ovarian cancer treated between July 2015 and August 2024. Overall survival (OS) and progression-free survival (PFS) were used to measure treatment effectiveness. Adverse events were graded according to the National Cancer Institute's Common Terminology Criteria for Adverse Events, version 3.0. Among 259 patients, 124 were treated with SeCRS followed by platinum-based chemotherapy (the surgery group), and 135 were treated with platinum-based chemotherapy alone (the chemotherapy group). All patients received olaparib tablets until disease progression. The median PFS in the surgery group was significantly longer than in the chemotherapy group (27.2 vs. 18.2 months; hazard ratio [HR], 0.46; 95 % confidence interval [CI], 0.35-0.62; p < 0.001). The median OS was significantly longer in the surgery group than in the chemotherapy group (68.1 vs. 50.5 months; HR, 0.57; 95 % CI 0.42-0.78; p < 0.001). The incidence and severity grades of adverse events did not differ significantly between the two groups. The findings of this study suggest that SeCRS followed by platinum-based chemotherapy and olaparib maintenance therapy results in longer OS and PFS than platinum-based chemotherapy followed by olaparib maintenance therapy alone for patients with BRCA-mutated platinum-sensitive recurrent ovarian cancer.