Outcomes of First-Line PARP Inhibitor Therapy in Ovarian Cancer: A Multicenter Retrospective Analysis

<b>Background:</b> Poly(ADP-ribose) polymerase (PARP) inhibitors have been established as a first-line maintenance therapy in advanced epithelial ovarian cancer (EOC) following platinum-based chemotherapy. While phase III trials have demonstrated significant progression-free survival (PFS) benefits with olaparib and niraparib, real-world data remain limited. <b>Methods:</b> This retrospective, multicenter real-world study included 179 patients with newly diagnosed epithelial ovarian treated with first-line maintenance olaparib or niraparib across 33 centers in Türkiye between January 2014 and March 2025. Clinical, pathological, and molecular data-including BRCA (Breast Cancer Susceptibility Gene) mutation status, origin, and variant classification-was collected. The primary endpoint was PFS, and secondary endpoints included overall survival (OS) and safety. Survival outcomes were analyzed using Kaplan-Meier methods. <b>Results:</b> Of 179 patients, 110 received olaparib and 69 received niraparib. BRCA mutations were present in 88.3% of patients, while 11.7% had unknown HRD status. Median follow-up was 16.5 months, and median PFS was not reached. Estimated PFS rates for the overall cohort were 91.0% at 6 months, 83.0% at 12 months, and 64.0% at 24 months. In the olaparib cohort, BRCA-mutant patients demonstrated PFS rates of 89%, 78%, 73%, and 64% at 6, 12, 18, and 24 months, respectively. In the niraparib cohort, corresponding PFS rates among BRCA-mutant patients were 87% at 6 months and 75% at 12 months. Patients harboring pathogenic BRCA variants experienced longer PFS compared with those with likely pathogenic variants. Any-grade adverse events occurred in 73.7% of patients, and grade 3-4 events in 29.6%, with hematologic toxicities predominating. Dose interruptions were more frequent with niraparib, while treatment discontinuation rates were low in both groups. No cases of myelodysplastic syndrome or acute myeloid leukemia were observed. <b>Conclusions:</b> In this large multicenter real-world cohort, first-line maintenance therapy with olaparib and niraparib provided durable PFS benefit in patients with advanced EOC, particularly among those with pathogenic BRCA mutations, confirming their effectiveness and manageable safety profiles in routine clinical practice.

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Journal
Journal of Clinical Medicine
Published
2026-02-22
DOI
https://doi.org/10.3390/jcm15041657
Primary Topic
PARP inhibition in cancer therapy
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article
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article

Outcomes of First-Line PARP Inhibitor Therapy in Ovarian Cancer: A Multicenter Retrospective Analysis

Ugur Ozberk, Ali Aytac, Bilgin Demir, Ozlem Topkaya et al.
Journal of Clinical Medicine
PARP inhibition in cancer therapy
article

Outcomes of First-Line PARP Inhibitor Therapy in Ovarian Cancer: A Multicenter Retrospective Analysis

Ugur Ozberk, Ali Aytac, Bilgin Demir, Ozlem Topkaya, Baris Koksal, F. Kose, Nejat Emre Öksüz, Gorkem Koymen, Atila Yıldırım, Fatih SELÇUKBİRİCİK, Murad Guliyev, Efnan Algin, HASAN ÇAĞRI YILDIRIM, Berkan Karabuğa, Esra Aşik, Nebi Serkan Demirci, ORHUN AKDOĞAN, Necdet Üskent, Öztürk Ateş, Ertuğrul Bayram, Serkan Menekşe, Elif Şahin, Erdinç NAYIR, Yasemin Bakkal Temi, Ceren Mordağ Çiçek, Sedat Biter, Ahmet Ünal, Özlem Özdemir, Bülent Erdoğan, Banu Öztürk, Gamze Gököz Doğu, Yüksel Urun, Bahadir Koylu, İsmail Bayrakci, Canan Yildiz, Zafer ARIK, Hacer Demir, KAAN HELVACI, Sema Türker, Ali Inal, Deniz Can Guven, Mustafa Sahbazlar, Huseyin Salih Semiz, Nadiye Sever, Kazim Uygun, Fatma Bugdayci Basal, Emine Bihter Cetin, Sercan On, Merve Keskinkilic, Ahmet Baklaci, Ozkan Alan, Teoman Sakalar, Halil Goksel Guzel, Kadriye Bir Yucel, Mehmet Emin Kalender
article en

Abstract

<b>Background:</b> Poly(ADP-ribose) polymerase (PARP) inhibitors have been established as a first-line maintenance therapy in advanced epithelial ovarian cancer (EOC) following platinum-based chemotherapy. While phase III trials have demonstrated significant progression-free survival (PFS) benefits with olaparib and niraparib, real-world data remain limited. <b>Methods:</b> This retrospective, multicenter real-world study included 179 patients with newly diagnosed epithelial ovarian treated with first-line maintenance olaparib or niraparib across 33 centers in Türkiye between January 2014 and March 2025. Clinical, pathological, and molecular data-including BRCA (Breast Cancer Susceptibility Gene) mutation status, origin, and variant classification-was collected. The primary endpoint was PFS, and secondary endpoints included overall survival (OS) and safety. Survival outcomes were analyzed using Kaplan-Meier methods. <b>Results:</b> Of 179 patients, 110 received olaparib and 69 received niraparib. BRCA mutations were present in 88.3% of patients, while 11.7% had unknown HRD status. Median follow-up was 16.5 months, and median PFS was not reached. Estimated PFS rates for the overall cohort were 91.0% at 6 months, 83.0% at 12 months, and 64.0% at 24 months. In the olaparib cohort, BRCA-mutant patients demonstrated PFS rates of 89%, 78%, 73%, and 64% at 6, 12, 18, and 24 months, respectively. In the niraparib cohort, corresponding PFS rates among BRCA-mutant patients were 87% at 6 months and 75% at 12 months. Patients harboring pathogenic BRCA variants experienced longer PFS compared with those with likely pathogenic variants. Any-grade adverse events occurred in 73.7% of patients, and grade 3-4 events in 29.6%, with hematologic toxicities predominating. Dose interruptions were more frequent with niraparib, while treatment discontinuation rates were low in both groups. No cases of myelodysplastic syndrome or acute myeloid leukemia were observed. <b>Conclusions:</b> In this large multicenter real-world cohort, first-line maintenance therapy with olaparib and niraparib provided durable PFS benefit in patients with advanced EOC, particularly among those with pathogenic BRCA mutations, confirming their effectiveness and manageable safety profiles in routine clinical practice.

Journal of Clinical MedicineVol. 15(4)
Trakya University (TR), Toros University (TR), Ministry of Health (TR), Izmir University (TR), Koç University (TR), Ankara University (TR), Karadeniz Technical University (TR), Manisa Celal Bayar University (TR), Başkent University (TR), Dokuz Eylül University (TR), Ege University (TR), Adana Hospital (TR), Memorial Ankara Hospital (TR), Ankara Numune Eğitim ve Araştırma Hastanesi (TR), Antalya Eğitim ve Araştırma Hastanesi (TR), Istanbul University-Cerrahpaşa (TR), Isparta University of Applied Sciences (TR), Şanlıurfa Mehmet Akif İnan Eğitim ve Araştırma Hastanesi (TR), Sağlık Bilimleri Üniversitesi (TR), Maltepe University (TR), Kahramanmaraş Sütçü İmam University (TR), Pamukkale University (TR), Mersin Üniversitesi (TR), Kocaeli Üniversitesi (TR), Afyon Kocatepe University (TR), Cukurova University (TR), Hacettepe University (TR), Marmara University (TR), Adnan Menderes University (TR), Gazi University (TR)
Good health and well-being
Openalex Percentile: Top 44%
PARP inhibition in cancer therapy
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