Evolution of the Ovarian Cancer Treatment Paradigm, Including Maintenance Treatment, in the US and Europe: A Real-World Chart Review Analysis (2017-2020) (028)

Objectives: The ovarian cancer (OC) treatment (tx) landscape has evolved with recent approvals from the FDA and EMA for several novel tx regimens, including first-line maintenance (1Lm) therapies. The antiangiogenic agent (VEGF inhibitor [VEGFi]) bevacizumab (bev) was the first 1Lm tx to be approved for advanced OC (Dec 2011 EMA; June 2018 FDA), followed by the PARPi olaparib (Dec 2018 FDA; June 2019 EMA), PARPi niraparib (Apr 2020 FDA; Oct 2020 EMA), and olaparib + bev (May 2020 FDA; Nov 2020 EMA). There is currently a lack of real-world data evaluating the impact of these approvals on the OC tx paradigm. This analysis describes patient (pt) characteristics, biomarker testing rates, and tx patterns for pts diagnosed with advanced OC in Europe and the US, with a focus on 1Lm. Methods: A retrospective chart review study of electronic medical records (EMRs) in Italy (IT), France (FR), Germany (DE), Spain, the UK, and the US was conducted for pts diagnosed with OC between Jun 1, 2017, and May 31, 2020. The study was conducted in line with Healthcare Market Research guidelines. Data were extracted by oncologists from EMRs to pt record forms (PRFs) and descriptively summarized. Pts with advanced (stage III/IV) disease were stratified by country and diagnosis date to provide information on tx patterns at different tx lines (Cohort 1: Jun 1, 2017-May 31, 2018; Cohort 2: Jun 1, 2018-May 31, 2019; and Cohort 3: Jun 1, 2019-May 31, 2020). Results: Overall, 416 oncologists completed PRFs for 7072 pts; 5386 pts had stage III/IV disease (Table). In total, 79.3%, 83.3%, and 84.7% of pts were tested for BRCA mutations or homologous recombination deficiency in Cohorts 1, 2, and 3, respectively. Of pts who received primary tx, 53.0%, 60.5%, and 65.8% received 1Lm in Cohorts 1, 2, and 3, respectively; the remainder received active surveillance. Use of 1Lm was highest in FR (71.5%; 710/993) and lowest in the UK (47.8%; 339/709). The number of pts receiving 1Lm increased (Cohort 1 vs 3) in all countries except DE. In Cohorts 1, 2, and 3, 81.6%, 73.2%, and 57.1% of pts received VEGFi monotherapy (mono), respectively; 11.9%, 20.9%, and 35.0% received PARPi mono; 2.3%, 3.5%, and 4.5% received PARPi + VEGFi tx; and 4.2%, 2.4%, and 3.4% received chemotherapy or other agents. For all cohorts combined, use of 1Lm PARPi mono was numerically highest in the US (40.0%; 174/435) and lowest in FR (12.0%; 85/710); VEGFi mono use was highest in FR (84.8%; 602/710) and lowest in the US (42.8%; 186/435). Funding: GlaxoSmithKline study (OneCDP#214555). Objectives: The ovarian cancer (OC) treatment (tx) landscape has evolved with recent approvals from the FDA and EMA for several novel tx regimens, including first-line maintenance (1Lm) therapies. The antiangiogenic agent (VEGF inhibitor [VEGFi]) bevacizumab (bev) was the first 1Lm tx to be approved for advanced OC (Dec 2011 EMA; June 2018 FDA), followed by the PARPi olaparib (Dec 2018 FDA; June 2019 EMA), PARPi niraparib (Apr 2020 FDA; Oct 2020 EMA), and olaparib + bev (May 2020 FDA; Nov 2020 EMA). There is currently a lack of real-world data evaluating the impact of these approvals on the OC tx paradigm. This analysis describes patient (pt) characteristics, biomarker testing rates, and tx patterns for pts diagnosed with advanced OC in Europe and the US, with a focus on 1Lm. Methods: A retrospective chart review study of electronic medical records (EMRs) in Italy (IT), France (FR), Germany (DE), Spain, the UK, and the US was conducted for pts diagnosed with OC between Jun 1, 2017, and May 31, 2020. The study was conducted in line with Healthcare Market Research guidelines. Data were extracted by oncologists from EMRs to pt record forms (PRFs) and descriptively summarized. Pts with advanced (stage III/IV) disease were stratified by country and diagnosis date to provide information on tx patterns at different tx lines (Cohort 1: Jun 1, 2017-May 31, 2018; Cohort 2: Jun 1, 2018-May 31, 2019; and Cohort 3: Jun 1, 2019-May 31, 2020). Results: Overall, 416 oncologists completed PRFs for 7072 pts; 5386 pts had stage III/IV disease (Table). In total, 79.3%, 83.3%, and 84.7% of pts were tested for BRCA mutations or homologous recombination deficiency in Cohorts 1, 2, and 3, respectively. Of pts who received primary tx, 53.0%, 60.5%, and 65.8% received 1Lm in Cohorts 1, 2, and 3, respectively; the remainder received active surveillance. Use of 1Lm was highest in FR (71.5%; 710/993) and lowest in the UK (47.8%; 339/709). The number of pts receiving 1Lm increased (Cohort 1 vs 3) in all countries except DE. In Cohorts 1, 2, and 3, 81.6%, 73.2%, and 57.1% of pts received VEGFi monotherapy (mono), respectively; 11.9%, 20.9%, and 35.0% received PARPi mono; 2.3%, 3.5%, and 4.5% received PARPi + VEGFi tx; and 4.2%, 2.4%, and 3.4% received chemotherapy or other agents. For all cohorts combined, use of 1Lm PARPi mono was numerically highest in the US (40.0%; 174/435) and lowest in FR (12.0%; 85/710); VEGFi mono use was highest in FR (84.8%; 602/710) and lowest in the US (42.8%; 186/435). Funding: GlaxoSmithKline study (OneCDP#214555).