Tyczynski J, Williams S, Gregory N, Garratt M, Tchakov I, Davis KL, Kaye JA, Korsnes J, Lewis J. Real-world treatment patterns for platinum-sensitive recurrent serous ovarian cancer: findings from a multinational medical record review. Poster presented at the 2015 American Society of Clinical Oncology Annual Meeting; June 2015. Chicago, IL. [abstract] J Clin Oncol. 2015 Jun; 33(Suppl):e16548. doi: 10.1200/jco.2015.33.15_suppl.e16548

Background:  Platinum-based chemotherapy is considered standard treatment for platinum-sensitive recurrent ovarian cancer (PSR OC). New targeted agents continue to be evaluated in this setting. Data on PSR OC treatment patterns in routine practice are needed to inform health–health technology and reimbursement assessments of standard and new treatments.

Methods:  We retrospectively reviewed a sample of medical records from three countries (United Kingdom [UK], Canada [CAN], and Netherlands [NL]) to assess PSR OC treatment patterns. Women determined to have serous PSR OC (progression-free interval of ≥ 6 months after 1st-line platinum completion) during 2009–2013 were selected, with the study index date defined as PSR OC diagnosis date. First-line treatments were evaluated as pre-index history, and 2nd-line or later treatments were assessed from index until death or last medical record.

Results:  In total, 421 patients were analyzed (n = 312 UK, 73 CAN, and 36 from the NL; median age at index: 61, 60, and 60 years). Germline BRCA testing was performed in 21%, 29%, and 20% of patients, respectively, with positive status (gBRCA1m/2m) identified in 29%, 29%, and 43% of those tested. Carboplatin + paclitaxel was the most common 1st-line regimen (78%, 89%, 83%). Maintenance following 1st-line occurred only in the UK (4%) and NL (3%), with bevacizumab used in all cases. The majority of patients (73%, 62%, 81%) received 2nd-line treatment (1st treatment for PSR OC), which involved a carboplatin-containing regimen in > 90% of cases; 7% received non-platinum regimens. Carboplatin + paclitaxel was most frequently used in 2nd-line (31%, 40%, 62%; median five cycles). Initiation of 3rd-line therapy occurred in 17%, 38%, and 38% of 2nd-line initiators.

Conclusions:  Platinum retreatment in the 2nd-line setting for PSR OC was the standard of care in this real-world review. Maintenance therapy was rarely employed as part of initial treatment, reflecting the current lack of an approved maintenance indication in CAN and only recent approval in the UK and NL.