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Description of a Retrospective Cohort of Epithelial Ovarian Cancer Patients with Brain Metastases: Evaluation of the Role of PARP Inhibitors in this Setting

Background: The incidence of brain metastases (BM) in patients with epithelial ovarian cancer (EOC) is low: 0.3–11%. The onset of BM has been regarded as a late event with limited treatment options and poor prognosis. This retrospective case series aims to explore the current management strategies w...

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Autores principales: Alizzi, Zena, Roxburgh, Patricia, Cartwright, Douglas, McLaren, Alistair, Park, Sarah, Jones, Rachel, Greening, Semini, Hudson, Emma, Green, Clare, Gray, Simon, Khalique, Saira, Karteris, Emmanouil, Hall, Marcia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10095324/
https://www.ncbi.nlm.nih.gov/pubmed/37048581
http://dx.doi.org/10.3390/jcm12072497
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author Alizzi, Zena
Roxburgh, Patricia
Cartwright, Douglas
McLaren, Alistair
Park, Sarah
Jones, Rachel
Greening, Semini
Hudson, Emma
Green, Clare
Gray, Simon
Khalique, Saira
Karteris, Emmanouil
Hall, Marcia
author_facet Alizzi, Zena
Roxburgh, Patricia
Cartwright, Douglas
McLaren, Alistair
Park, Sarah
Jones, Rachel
Greening, Semini
Hudson, Emma
Green, Clare
Gray, Simon
Khalique, Saira
Karteris, Emmanouil
Hall, Marcia
author_sort Alizzi, Zena
collection PubMed
description Background: The incidence of brain metastases (BM) in patients with epithelial ovarian cancer (EOC) is low: 0.3–11%. The onset of BM has been regarded as a late event with limited treatment options and poor prognosis. This retrospective case series aims to explore the current management strategies with particular emphasis on the use of PARP inhibitors and outcomes, as well as identification of other prognostic indicators. Methods: A total of 39 ovarian cancer patients with brain metastases were identified from eight cancer centres in the UK. Clinical characteristics, details of management, and survival data were collected. Results: A total of 14/39 had BM as their first site of relapse. The majority (29 patients) received systemic treatments in addition to local radiotherapy (RT)/surgery. Nineteen patients had BRCA mutations (one somatic), one had a RAD51C mutation, and eighteen were BRCA wild type; one was unknown. A total of 14/39 patients received maintenance PARP inhibitors. As is well known, patients who received PARPi had consistently better outcomes. This was no different for those who received PARPi as part of the management of their BM. Platinum sensitivity and receiving more than one modality of therapy (e.g., radiation +/− chemotherapy and PARPi) for BM were also good prognostic indicators. Median PFS/OS for those treated with chemotherapy and either RT or surgery, then PARP inhibitor maintenance, have not been reached after a median of 33 months follow up. Conclusions: As with abdominal relapse, maintenance treatment with PARP inhibitors also has a valuable role in managing BMs in EOC patients.
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spelling pubmed-100953242023-04-13 Description of a Retrospective Cohort of Epithelial Ovarian Cancer Patients with Brain Metastases: Evaluation of the Role of PARP Inhibitors in this Setting Alizzi, Zena Roxburgh, Patricia Cartwright, Douglas McLaren, Alistair Park, Sarah Jones, Rachel Greening, Semini Hudson, Emma Green, Clare Gray, Simon Khalique, Saira Karteris, Emmanouil Hall, Marcia J Clin Med Article Background: The incidence of brain metastases (BM) in patients with epithelial ovarian cancer (EOC) is low: 0.3–11%. The onset of BM has been regarded as a late event with limited treatment options and poor prognosis. This retrospective case series aims to explore the current management strategies with particular emphasis on the use of PARP inhibitors and outcomes, as well as identification of other prognostic indicators. Methods: A total of 39 ovarian cancer patients with brain metastases were identified from eight cancer centres in the UK. Clinical characteristics, details of management, and survival data were collected. Results: A total of 14/39 had BM as their first site of relapse. The majority (29 patients) received systemic treatments in addition to local radiotherapy (RT)/surgery. Nineteen patients had BRCA mutations (one somatic), one had a RAD51C mutation, and eighteen were BRCA wild type; one was unknown. A total of 14/39 patients received maintenance PARP inhibitors. As is well known, patients who received PARPi had consistently better outcomes. This was no different for those who received PARPi as part of the management of their BM. Platinum sensitivity and receiving more than one modality of therapy (e.g., radiation +/− chemotherapy and PARPi) for BM were also good prognostic indicators. Median PFS/OS for those treated with chemotherapy and either RT or surgery, then PARP inhibitor maintenance, have not been reached after a median of 33 months follow up. Conclusions: As with abdominal relapse, maintenance treatment with PARP inhibitors also has a valuable role in managing BMs in EOC patients. MDPI 2023-03-25 /pmc/articles/PMC10095324/ /pubmed/37048581 http://dx.doi.org/10.3390/jcm12072497 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Alizzi, Zena
Roxburgh, Patricia
Cartwright, Douglas
McLaren, Alistair
Park, Sarah
Jones, Rachel
Greening, Semini
Hudson, Emma
Green, Clare
Gray, Simon
Khalique, Saira
Karteris, Emmanouil
Hall, Marcia
Description of a Retrospective Cohort of Epithelial Ovarian Cancer Patients with Brain Metastases: Evaluation of the Role of PARP Inhibitors in this Setting
title Description of a Retrospective Cohort of Epithelial Ovarian Cancer Patients with Brain Metastases: Evaluation of the Role of PARP Inhibitors in this Setting
title_full Description of a Retrospective Cohort of Epithelial Ovarian Cancer Patients with Brain Metastases: Evaluation of the Role of PARP Inhibitors in this Setting
title_fullStr Description of a Retrospective Cohort of Epithelial Ovarian Cancer Patients with Brain Metastases: Evaluation of the Role of PARP Inhibitors in this Setting
title_full_unstemmed Description of a Retrospective Cohort of Epithelial Ovarian Cancer Patients with Brain Metastases: Evaluation of the Role of PARP Inhibitors in this Setting
title_short Description of a Retrospective Cohort of Epithelial Ovarian Cancer Patients with Brain Metastases: Evaluation of the Role of PARP Inhibitors in this Setting
title_sort description of a retrospective cohort of epithelial ovarian cancer patients with brain metastases: evaluation of the role of parp inhibitors in this setting
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10095324/
https://www.ncbi.nlm.nih.gov/pubmed/37048581
http://dx.doi.org/10.3390/jcm12072497
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