Real-world post-2020 first-line maintenance treatment patterns in patients with advanced ovarian cancer in the US

To describe first-line maintenance (1LM) treatment patterns since 1 January 2020, for real-world patients with newly diagnosed advanced ovarian cancer (aOC).

This retrospective study used a US-nationwide electronic health record-derived deidentified database. Eligible patients were aged ≥ 18 years with stage III/IV epithelial OC and initiated first-line platinum-based chemotherapy±bevacizumab (index; 01Jan2020-28Feb2023). Baseline characteristics and 1LM treatment patterns were summarized overall and by BRCA status.

Among 599 eligible patients (median [interquartile range] age, 67 [59-74] years; 59.8% White; 50.3% stage III disease), 15.5% had BRCA-mutated (BRCAm), 72.3% BRCA wild-type (BRCAwt), and 12.2% unknown BRCA status. Overall, 289 patients (48.2%) received 1LM therapy (poly(ADP-ribose) polymerase inhibitor [PARPi] monotherapy, 23.4%; bevacizumab monotherapy, 14.7%; bevacizumab+PARPi, 7.8%; other therapies, 2.3%). PARPi monotherapy was most common among patients with BRCAm (47.3%) versus BRCAwt (21.7%) or BRCA-unknown (2.7%) status. The same was true for 1LM bevacizumab+PARPi (BRCAm, 16.1%; BRCAwt, 7.4%; BRCA-unknown, 0%). Bevacizumab monotherapy was most common among patients with BRCAwt (18.7%) versus BRCAm (3.2%) or BRCA-unknown (5.5%) status.

Fewer than half of included patients with aOC received 1LM treatment in the real-world setting. More work is needed to understand reasons underlying real-world 1LM treatment choice for patients with aOC.