167 Safety and quality of life of first-line maintenance olaparib plus bevacizumab in older patients with advanced ovarian cancer in the PAOLA-1 trial

Abstract

six cycles. 39% (24/61) of patients inoperable after 3 cycles changed chemotherapy regimens; 42% (10/24) of the latter switched to weekly paclitaxel, 21% (5/24) to bevacizumabbased regimen, and 13% (3/24) to carboplatin + liposomal doxorubcin (Caelyx ® ). 25% (6/24) had palliative aromatase inhibitors or stopped chemo entirely. Of those who had their chemotherapy changed, only 1 patient in bevacizumab group (4%) achieved optimal debulking. Median overall suvival(OS) in those who switched regimen was 17.47 vs 37.40 months in those who did not, p=0.79. Conclusion* Switching chemotherapy regimen in previously inoperable patients did not lead to improved OS. This may reflect the poor prognosis conferred by inadequate response to platinum-based therapy, and needs further evaluation. Though the numbers in each group were small, a change to bevacizumab-based regimen did not appear to improve outcomes. The ICON 8b study will provide further information regarding bevacizumab's role in the neoadjuvant setting.

Efficacy and safety of PARP inhibitors in elderly patients with advanced ovarian cancer: a systematic review and meta-analysis

“…Quality of life and geriatric assessment data are under evaluation. 37 The age subgroup of patients older than 75 years was explored only by a post hoc exploratory analysis of the ARIEL3 trial. The small subset (n=25) of patients older than 75 years exhibited a non-significant benefit from rucaparib compared with placebo in progression-free survival (9.2 vs 5.5 months; p=0.16), with a similar safety profile in comparison with younger age subgroups.…”

“…In a sub-analysis of the PAOLA-1 study considering the cut-off age of 70 years, a slight increase of adverse events was reported among patients aged >70 than <70 patients treated with olaparib plus bevacizumab—for example, severe anemia occurred in 21.2% vs 16.5%, severe neutropenia in 9.7% vs 5.1% patients, severe hypertension in 26.9% vs 16.7%, respectively. Quality of life and geriatric assessment data are under evaluation 37. The age subgroup of patients older than 75 years was explored only by a post hoc exploratory analysis of the ARIEL3 trial.…”

Ovarian cancer in the older patient: where are we now? What to do next?

“…However, the impact of age on the treatment tolerance and efficacy has been investigated in several subgroup analyses and these did not identify major difficulties in the management of (selected) older patients. 110 In recurrent disease in patients eligible for platinum and no prior PARPi, olaparib, 107 niraparib, 108 and rucaparib 109 demonstrated a benefit in cancer control; and some data specific to older patients have been reported; for olaparib, 111 niraparib, 11 and rucaparib 112 were summarized in a review of the Young Internal Society of Geriatric Oncology in 2019 that highlighted the need to consider pharmaceutical optimization in routine care for older patients, given the high prevalence of polypharmacy in these patients. 113 No difference on toxicity was shown between patients aged < or ⩾65 years for olaparib, 111 for patients aged < or ⩾70 years for niraparib, 11 and in three age subgroups (<65 years, 65–74 years, and ⩾75 years) for rucaparib.…”