Progression-free survival and safety at 3.5 years of follow-up: results from the randomised phase 3 PRIMA/ENGOT-OV26/GOG-3012 trial of niraparib maintenance treatment in patients with newly diagnosed ovarian cancer

Antonio González-Martín, Bhavana Pothuri, Ignace Vergote, Whitney Graybill, Domenica Lorusso, Colleen C. McCormick, Gilles Freyer, Floor Backes, Florian Heitz, Andrés Redondo, Richard G. Moore, Christof Vulsteke, Roisin E. O'Cearbhaill, Izabela A. Malinowska, Luda Shtessel, Natalie Compton, Mansoor R. Mirza, Bradley J. Monk

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: To report updated long-term efficacy and safety from the double-blind, placebo-controlled, phase 3 PRIMA/ENGOT-OV26/GOG-3012 study (NCT02655016). Methods: Patients with newly diagnosed advanced ovarian cancer with complete or partial response (CR or PR) to first-line platinum-based chemotherapy received niraparib or placebo once daily (2:1 ratio). Stratification factors were best response to first-line chemotherapy regimen (CR/PR), receipt of neoadjuvant chemotherapy (yes/no), and homologous recombination deficiency (HRD) status (deficient [HRd]/proficient [HRp] or not determined). Updated (ad hoc) progression-free survival (PFS) data (as of November 17, 2021) by investigator assessment (INV) are reported. Results: In 733 randomised patients (niraparib, 487; placebo, 246), median PFS follow-up was 3.5 years. Median INV-PFS was 24.5 versus 11.2 months (hazard ratio, 0.52; 95% confidence interval [CI], 0.40–0.68) in the HRd population and 13.8 versus 8.2 months (hazard ratio, 0.66; 95% CI, 0.56–0.79) in the overall population for niraparib and placebo, respectively. In the HRp population, median INV-PFS was 8.4 versus 5.4 months (hazard ratio, 0.65; 95% CI, 0.49–0.87), respectively. Results were concordant with the primary analysis. Niraparib-treated patients were more likely to be free of progression or death at 4 years than placebo-treated patients (HRd, 38% versus 17%; overall, 24% versus 14%). The most common grade ≥ 3 treatment-emergent adverse events in niraparib patients were thrombocytopenia (39.7%), anaemia (31.6%), and neutropenia (21.3%). Myelodysplastic syndromes/acute myeloid leukaemia incidence rate (1.2%) was the same for niraparib- and placebo-treated patients. Overall survival remained immature. Conclusions: Niraparib maintained clinically significant improvements in PFS with 3.5 years of follow-up in patients with newly diagnosed advanced ovarian cancer at high risk of progression irrespective of HRD status. No new safety signals were identified.

Original languageEnglish (US)
Article number112908
JournalEuropean Journal of Cancer
Volume189
DOIs
StatePublished - Aug 2023
Externally publishedYes

Keywords

  • Advanced ovarian cancer
  • Maintenance therapy
  • Niraparib
  • PARP inhibitor

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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