Management and Clinical Outcomes of Patients with Advanced Ovarian Cancer in Routine Clinical Practice in Spain: The...

The OVOC study was carried out to evaluate the management and clinical evolution of patients with advanced ovarian cancer (AOC) in routine clinical practice in Spain.

A retrospective study was made in women diagnosed with advanced epithelial ovarian, fallopian tube, or primary peritoneal cancer (FIGO IIIB-IV) who had received at least one line of treatment between 2013 and 2016, before the establishment of poly ADP ribose polymerase (PARP) inhibitors as first-line treatment.

A total of 400 patients (median age: 61.7 years; FIGO IIIC: 60.0%; high-grade serous carcinoma: 75.0%) received a median of two therapy lines. Primary and interval debulking surgery was performed in 37.0% and 54.3% of the patients. Germline BRCA1 and BRCA2 mutations were found in 16.2% and 12.0% of the patients. The median progression-free survival (PFS) from the start of the first-/second-/third-line of treatment was 14.2/8.7/4.5 months. The median treatment-free interval (TFI) to the start of the second line was 9.9 months. The median overall survival (OS) was 42.6 months. At first relapse, 65.9% of the patients were platinum-sensitive and 34.1% platinum-resistant. Biologic therapies were administered in 25.2% of the platinum-sensitive and 16.2% of the platinum-resistant patients. Patients harboring BRCA mutations had a lower risk of progression/relapse after the first (BRCA1 and BRCA2 mutation versus native: p < 0.0001) and second line (BRCA1 and BRCA2 mutation versus native: p = 0.021 and p = 0.037, respectively). Patients with BRCA2 mutations had a lower mortality risk than those without (p = 0.015). The median PFS was significantly higher in patients receiving targeted therapy in the first (17.4 versus 11.6 months; p = 0.039) and second line (11.1 versus 7.8 months; p < 0.001).

This study provides real-world data on therapeutic management and outcomes in AOC patients in Spain. A longer PFS was achieved in patients receiving targeted therapies. BRCA1/2 mutations were a favorable prognostic factor for PFS and BRCA2 mutation for OS.