Comparison of Survival Outcomes with First-Line PARP Inhibitor Maintenance According to BRCA Mutation and Homologous Recombination Deficiency Status in Advanced Ovarian Cancer: A Single-Center Retrospective Cohort Study
- 1Department of Obstetrics and Gynecology, Institute of Women’s Life Medical Science, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea
- 2Department of Obstetrics and Gynecology, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea
Abstract
Background/Objectives: First-line poly(ADP-ribose) polymerase inhibitor (PARPi) maintenance is standard in advanced ovarian cancer, but direct comparisons between active regimens within biomarker-defined groups are limited. We compared survival outcomes after first-line PARPi maintenance according to BRCA mutation and homologous recombination deficiency (HRD) status. Methods: This single-center retrospective cohort included 218 patients who initiated olaparib, olaparib plus bevacizumab, or niraparib after first-line platinum-based chemotherapy. Progression-free survival (PFS) and overall survival (OS) were measured from maintenance initiation. We compared olaparib with niraparib in BRCA-mutated disease and olaparib plus bevacizumab with niraparib in HRD-positive, BRCA-wild-type disease. Results: Overall, 82 patients received olaparib, 33 olaparib plus bevacizumab, and 103 niraparib. Median follow-up was 23.9 months. In BRCA-mutated disease, 2-year PFS was 68.2% with olaparib (n = 81) and 69.0% with niraparib (n = 44; niraparib vs. olaparib: hazard ratio [HR] 1.14, 95% confidence interval [CI] 0.60–2.17; log-rank p = 0.695). In HRD-positive, BRCA-wild-type disease, 2-year PFS was 81.0% with olaparib plus bevacizumab (n = 22) and 62.6% with niraparib (n = 51; niraparib vs. combination: HR 1.58, 95% CI 0.61–4.09; log-rank p = 0.338). A bevacizumab-containing induction regimen was more frequent in the combination group (13/22 vs. 2/51), and only seven deaths occurred in this comparison. Conclusions: Neither comparison showed a statistically significant PFS difference, and the study was not powered to evaluate OS or to establish superiority or equivalence. The small HRD-positive comparison and differences in prior treatment preclude a definitive conclusion about the relative efficacy of olaparib plus bevacizumab and niraparib.
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BibTeX
@article{choi2026comparison,
title = {{Comparison of Survival Outcomes with First-Line PARP Inhibitor Maintenance According to BRCA Mutation and Homologous Recombination Deficiency Status in Advanced Ovarian Cancer: A Single-Center Retrospective Cohort Study}},
author = {Young Joo Choi and Jung-Yun Lee and Eun Ji Nam and Sang Wun Kim and Sunghoon Kim and Yong Jae Lee},
journal = {Cancers},
year = {2026},
month = oct,
doi = {10.3390/cancers18213508},
url = {https://www.mdpi.com/2072-6694/18/21/3508},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Comparison of Survival Outcomes with First-Line PARP Inhibitor Maintenance According to BRCA Mutation and Homologous Recombination Deficiency Status in Advanced Ovarian Cancer: A Single-Center Retrospective Cohort Study
AU - Young Joo Choi
AU - Jung-Yun Lee
AU - Eun Ji Nam
AU - Sang Wun Kim
AU - Sunghoon Kim
AU - Yong Jae Lee
PY - 2026
DA - 2026/10/31
JO - Cancers
DO - 10.3390/cancers18213508
UR - https://www.mdpi.com/2072-6694/18/21/3508
AB - Background/Objectives: First-line poly(ADP-ribose) polymerase inhibitor (PARPi) maintenance is standard in advanced ovarian cancer, but direct comparisons between active regimens within biomarker-defined groups are limited. We compared survival outcomes after first-line PARPi maintenance according to BRCA mutation and homologous recombination deficiency (HRD) status. Methods: This single-center retrospective cohort included 218 patients who initiated olaparib, olaparib plus bevacizumab, or niraparib after first-line platinum-based chemotherapy. Progression-free survival (PFS) and overall survival (OS) were measured from maintenance initiation. We compared olaparib with niraparib in BRCA-mutated disease and olaparib plus bevacizumab with niraparib in HRD-positive, BRCA-wild-type disease. Results: Overall, 82 patients received olaparib, 33 olaparib plus bevacizumab, and 103 niraparib. Median follow-up was 23.9 months. In BRCA-mutated disease, 2-year PFS was 68.2% with olaparib (n = 81) and 69.0% with niraparib (n = 44; niraparib vs. olaparib: hazard ratio [HR] 1.14, 95% confidence interval [CI] 0.60–2.17; log-rank p = 0.695). In HRD-positive, BRCA-wild-type disease, 2-year PFS was 81.0% with olaparib plus bevacizumab (n = 22) and 62.6% with niraparib (n = 51; niraparib vs. combination: HR 1.58, 95% CI 0.61–4.09; log-rank p = 0.338). A bevacizumab-containing induction regimen was more frequent in the combination group (13/22 vs. 2/51), and only seven deaths occurred in this comparison. Conclusions: Neither comparison showed a statistically significant PFS difference, and the study was not powered to evaluate OS or to establish superiority or equivalence. The small HRD-positive comparison and differences in prior treatment preclude a definitive conclusion about the relative efficacy of olaparib plus bevacizumab and niraparib.
SN - 2072-6694
ER -