Stereotactic radiotherapy for managing ovarian cancer oligoprogression under poly (ADP-ribose) polymerase inhibitors (PARPi).

Autor:	Durante S; Division of Radiation Oncology, European Institute of Oncology, IEO, IRCCS, Milan, Italy stefano.durante@ieo.it., Cuccia F; Radiation Oncology, ARNAS Civico Hospital, Palermo, Italy., Rigo M; Advanced Radiation Oncology Department, IRCCS Ospedale Sacro Cuore Don Calabria, Negrar, Veneto, Italy., Caminiti G; UOC Radioterapia, ASP 7 Ragusa, Ragusa, Sicilia, Italy., Mastroleo F; Division of Radiation Oncology, European Institute of Oncology, IEO, IRCCS, Milan, Italy.; Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy., Lazzari R; Division of Radiation Oncology, European Institute of Oncology, IEO, IRCCS, Milan, Italy., Corrao G; Division of Radiation Oncology, European Institute of Oncology, IEO, IRCCS, Milan, Italy.; Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy., Caruso G; Department of Experimental Medicine, University of Rome La Sapienza, Rome, Lazio, Italy.; Divison of Gynecologic Oncology, European Institute of Oncology, IEO, IRCCS, Milan, Italy., Vigorito S; Unit of Medical Physics, European Institute of Oncology IRCCS, Milan, Italy., Cattani F; Unit of Medical Physics, European Institute of Oncology IRCCS, Milan, Italy., Ferrera G; Radiation Oncology, ARNAS Civico Hospital, Palermo, Italy., Chiantera V; Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, Sicilia, Italy.; Department of Gynecologic Oncology, Istituto Nazionale Tumori - IRCCS Fondazione G. Pascale, Naples, Italy., Alongi F; Advanced Radiation Oncology Department, IRCCS Ospedale Sacro Cuore Don Calabria, Negrar, Veneto, Italy.; University of Brescia, Brescia, Italy., Colombo N; Gynecology Program, European Institute of Oncology, IEO, IRCCS, Milan, Italy.; Department of Medicine and Surgery, University of Milan-Bicocca, Milan, Italy., Jereczek-Fossa BA; Division of Radiation Oncology, European Institute of Oncology, IEO, IRCCS, Milan, Italy.; Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy.
Jazyk:	angličtina
Zdroj:	International journal of gynecological cancer : official journal of the International Gynecological Cancer Society [Int J Gynecol Cancer] 2024 Aug 05; Vol. 34 (8), pp. 1232-1239. Date of Electronic Publication: 2024 Aug 05.
DOI:	10.1136/ijgc-2024-005361
Abstrakt:	Objective: Poly (ADP-ribose) polymerase inhibitors (PARPi) have become a new standard of care for the maintenance treatment of advanced epithelial ovarian cancer. This study aims to evaluate the efficacy and safety of combining stereotactic body radiotherapy with PARPi continuation as a strategy to treat ovarian cancer oligoprogression on PARPi. Methods: This is a multicenter retrospective study including ovarian cancer patients treated with stereotactic body radiotherapy and PARPi continuation for oligoprogression under PARPi maintenance therapy between June 2012 and May 2023 in three Italian centers. PARPi treatment was continued until further disease progression or unacceptable toxicity. The primary endpoint was the next-line systemic therapy-free interval. The Kaplan-Meier method was used to assess local control, progression-free survival, and overall survival. Univariate and multivariate Cox regression analyses were performed to evaluate potential clinical outcomes predictors. Results: 46 patients were included, with a total of 89 lesions treated over 63 radiotherapy treatments. Lymph nodes were the most frequently treated lesions (80, 89.9%), followed by visceral lesions (8, 9%) and one case with a bone lesion (1.1%). Median follow-up was 25.9 months (range 2.8-122). The median next-line systemic therapy-free interval was 12.4 months (95% CI 8.3 to 19.5). A number of prior chemotherapy lines greater than five was significantly associated with a reduced next-line systemic therapy-free interval (HR 3.21, 95% CI 1.11 to 9.32, p=0.032). At the time of analysis, 32 (69.6%) patients started a new systemic therapy regimen, while 14 (30.4%) remained on the PARPi regimen. The 2-year progression-free survival, local failure-free survival, and overall survival rates were 10.7%, 78.1%, and 76.5%, respectively. Four patients (8.7%) experienced acute toxicity with G1 gastrointestinal events. Conclusion: Stereotactic body radiotherapy combined with PARPi continuation may be an effective and safe strategy for managing ovarian cancer patients with oligoprogression on PARPi maintenance therapy. Prospective research is warranted to shed more light on this approach. Competing Interests: Competing interests: BAJ-F has received speakers fees from Roche, Bayer, Janssen, Carl Zeiss, Ipsen, Accuray, Astellas, Elekta, and IBA Astra Zeneca, all outside the current project. (© IGCS and ESGO 2024. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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