Maintenance olaparib plus bevacizumab in patients with newly diagnosed advanced high-grade ovarian cancer: Main analysis of second progression-free survival in the phase III PAOLA-1/ENGOT-ov25 trial

• DOI: 10.1016/j.ejca.2022.07.022
• Publication Date: 2022-09-05T07:52:17Z
• Authors: Antonio González-...; Christophe Desauw; Florian Heitz; Claire Cropet; Piera Gargiulo; Regina Berger; Hiroyuki Ochi; Ignace Vergote; Nicoletta Colombo; Mansoor R. Mirza; Youssef Tazi; Ulrich Canzler; Claudio Zamagni; Eva M. Guerra-Alia; Charles B. Levaché; Frederik Marmé; Fernando Bazan; Nikolaus de Gregorio; Nadine Dohollou; Peter A. Fasching; Giovanni Scambia; María J. Rubio-Pérez; Tsveta Milenkova; Cristina Costan; Patricia Pautier; Isabelle Ray-Coquard
• Keywords: Antineoplastic Agents; Carcinoma, Ovarian Epithelial; Poly(ADP-ribose) Polymerase Inhibitors; Piperazines; 03 medical and health sciences; Olaparib; 0302 clinical medicine; Second progression-free survival; Double-Blind Method; Ovarian cancer; Antineoplastic Combined Chemotherapy Protocols; Humans; Ovarian Neoplasms; Science & Technology; Progression-Free Survival; 3. Good health; Bevacizumab; PARP inhibitor; Oncology; Antiangiogenic agent; Antiangiogenic agent; Bevacizumab; Olaparib; Ovarian cancer; PARP inhibitor; Second progression-free survival;; Phthalazines; Female; Life Sciences & Biomedicine

PAOLA-1/ENGOT-ov25 (NCT02477644) demonstrated a significant progression-free survival (PFS) benefit with maintenance olaparib plus bevacizumab versus placebo plus bevacizumab in newly diagnosed, advanced ovarian cancer. We report the prespecified main second progression-free survival (PFS2) analysis for PAOLA-1.This randomised, double-blind, phase III trial was conducted in 11 countries. Eligible patients had newly diagnosed, advanced, high-grade ovarian cancer and were in response after first-line platinum-based chemotherapy plus bevacizumab. Patients were randomised 2:1 to olaparib (300 mg twice daily) or placebo for up to 24 months; all patients received bevacizumab (15 mg/kg every 3 weeks) for up to 15 months. Primary PFS end-point was reported previously. Time from randomisation to second disease progression or death was a key secondary end-point included in the hierarchical-testing procedure.After a median follow-up of 35.5 months and 36.5 months, respectively, median PFS2 was 36.5 months (olaparib plus bevacizumab) and 32.6 months (placebo plus bevacizumab), hazard ratio 0.78; 95% confidence interval (CI) 0.64-0.95; P = 0.0125. Median time to second subsequent therapy or death was 38.2 months (olaparib plus bevacizumab) and 31.5 months (placebo plus bevacizumab), hazard ratio 0.78; 95% CI 0.64-0.95; P = 0.0115. Seventy-two (27%) patients in the placebo plus bevacizumab group received a poly(ADP-ribose) polymerase inhibitor as first subsequent therapy. No new safety signals were observed for olaparib plus bevacizumab.In newly diagnosed, advanced ovarian cancer, maintenance olaparib plus bevacizumab provided continued benefit beyond first progression, with a significant PFS2 improvement and a time to second subsequent therapy or death delay versus placebo plus bevacizumab.