medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2022-16-9-77-83medsovet-6919Research ArticleОНКОГИНЕКОЛОГИЯONCOGYNECOLOGYОлапариб в первой линии терапии BRCA-ассоциированного рака яичников: собственный опыт использования в программе расширенного доступаOlaparib maintenance therapy after frontline chemotherapy in patients with BRCA-mutated ovarian cancer: real-world results in expanded access programhttps://orcid.org/0000-0003-4443-9974РумянцевА. А.RumyantsevA. A.

Румянцев Алексей Александрович – кандидат медицинских наук, старший научный сотрудник онкологического отделения лекарственных методов лечения (химиотерапевтического) №4 отдела лекарственного лечения НИИ клинической онкологии имени академика РАН и РАМН Н.Н. Трапезникова.

115478, Москва, Каширское шоссе, д. 24.

Alexey А. Rumyantsev - Cand. Sci. (Med.), Senior Research Associate, Department of Chemotherapy No. 4, Blokhin National Medical Research Center of Oncology.

24, Kashirskoye Shosse, Moscow, 115478.

alexeymma@gmail.comhttps://orcid.org/0000-0002-6104-7473ТюляндинаА. С.TyulyandinaA. S.

Тюляндина Александра Сергеевна - доктор медицинских наук, заведующая отделением лекарственных методов лечения (химиотерапевтического) №4 отдела лекарственного лечения НИИ клинической онкологии имени академика РАН и РАМН Н.Н. Трапезникова, НМИЦ онкологии им. Н.Н. Блохина; профессор кафедры онкологии института клинической медицины имени Н.В. Склифосовского, ПМГМУ им. И.М. Сеченова (Сеченовский Университет).

115478, Москва, Каширское шоссе, д. 24; 119991, Москва, ул. Большая Пироговская, д. 6, стр. 1.

Alexandra S. Tyulyandina - Dr. Sci. (Med.), Head of the Department, Department of Chemotherapy No. 4, Blokhin National Medical Research Center of Oncology; Professor of the Department of Oncology, Institute of Clinical Medicine named after N.V. Sklifosovsky, Sechenov First Moscow State Medical University (Sechenov University).

24, Kashirskoye Shosse, Moscow, 115478; 6, Bldg. 1, Bolshaya Pirogovskaya St., Moscow, 119991.

atjulandina@mail.ruhttps://orcid.org/0000-0001-9864-3837ПокатаевИ. А.PokataevI. A.

Покатаев Илья Анатольевич – доктор медицинских наук, руководитель службы химиотерапевтического лечения.

117152, Москва, Загородное шоссе, д. 18а.

Ilya А. Pokataev - Dr. Sci. (Med.), Head of the Medical Oncology Department, Moscow City Clinical Cancer Hospital No. 1.

18, letter A, Zagoronoe Shosse, Moscow, 117152.

pokia@mail.ruhttps://orcid.org/0000-0002-6666-549XИсраелянЭ. Р.IsraelyanE. R.

Исраелян Эдгар Рудикович - ординатор кафедры онкологии ФДПО.

117997, Москва, ул. Островитянова, д. 1.

Edgar R. Israelyan - Clinical Resident, Department of Oncology, Pirogov Russian National Research Medical University.

1, Ostrovityanov St., Moscow, 117997.

e.israelyan@yandex.ruhttps://orcid.org/0000-0003-4754-2352АбрамовМ. Е.AbramovM. Е.

Абрамов Михаил Евгеньевич - кандидат медицинских наук, старший научный сотрудник онкологического отделения лекарственных методов лечения (химиотерапевтического) №4 отдела лекарственного лечения НИИ клинической онкологии имени академика РАН и РАМН Н.Н. Трапезникова.

115478, Москва, Каширское шоссе, д. 24.

Mikhail Е. Abramov - Cand. Sci. (Med.), Senior Research Associate, Department of Chemotherapy No. 4, Blokhin National Medical Research Center of Oncology.

24, Kashirskoye Shosse, Moscow, 115478.

abramovm67@mail.ruhttps://orcid.org/0000-0002-2624-3030ЛудА. Н.LudH. N.

Луд Анна Николаевна – кандидат медицинских наук, научный сотрудник онкологического отделения лекарственных методов лечения (химиотерапевтического) №4 отдела лекарственного лечения НИИ клинической онкологии имени академика РАН и РАМН Н.Н. Трапезникова.

115478, Москва, Каширское шоссе, д. 24.

Hanna N. Lud - Cand. Sci. (Med.), Research Associate, Department of Chemotherapy No. 4, Blokhin National Medical Research Center of Oncology.

24, Kashirskoye Shosse, Moscow, 115478.

lud.anna.18@gmail.comhttps://orcid.org/0000-0001-9807-2229ТюляндинС. А.TyulyandinS. A.

Тюляндин Сергей Алексеевич – доктор медицинских наук, профессор, главный научный сотрудник отделения лекарственных методов лечения (химиотерапевтического) №2 отдела лекарственного лечения НИИ клинической онкологии имени академика РАН и РАМН Н.Н. Трапезникова.

115478, Москва, Каширское шоссе, д. 24.

Sergey А. Tyulyandin - Dr. Sci. (Med.), Chief Scientific Associate, Department of Chemotherapy No. 2, Blokhin National Medical Research Center of Oncology.

24, Kashirskoye Shosse, Moscow, 115478.

stjulandin@gmail.comНациональный медицинский исследовательский центр онкологии имени Н.Н. БлохинаРоссияBlokhin National Medical Research Center of OncologyRussian FederationНациональный медицинский исследовательский центр онкологии имени Н.Н. Блохина; Первый Московский государственный медицинский университет имени И.М. Сеченова (Сеченовский Университет)РоссияBlokhin National Medical Research Center of Oncology; Sechenov First Moscow State Medical University (Sechenov University)Russian FederationГородская клиническая онкологическая больница №1РоссияMoscow City Clinical Cancer Hospital No. 1Russian FederationРоссийский национальный исследовательский медицинский университет имени Н.И. ПироговаРоссияPirogov Russian National Research Medical UniversityRussian Federation202218062022097783Copyright © Румянцев А.А., Тюляндина А.С., Покатаев И.А., Исраелян Э.Р., Абрамов М.Е., Луд А.Н., Тюляндин С.А., 20222022Румянцев А.А., Тюляндина А.С., Покатаев И.А., Исраелян Э.Р., Абрамов М.Е., Луд А.Н., Тюляндин С.А.Rumyantsev A.A., Tyulyandina A.S., Pokataev I.A., Israelyan E.R., Abramov M.Е., Lud H.N., Tyulyandin S.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/6919Введение

Введение. Олапариб - единственный представитель класса ингибиторов PARP, одобренный в России для поддерживающей терапии BRCA-позитивного рака яичников после первой линии химиотерапии. Была проанализирована эффективность и безопасность применения олапариба по данному показанию в рамках реальной клинической практики.

Цель исследования - оценить эффективность ингибиторов PARP в реальной клинической практике.

Материалы и методы

Материалы и методы. В исследование включались пациентки с III-IV стадией BRCA-ассоциированного рака яичников, которым проводилась терапия олапарибом в рамках программы расширенного доступа с марта 2019 г. по декабрь 2020 г. Краткие критерии включения в исследование: серозный или эндометриоидный рак яичников, патогенная мутация в генах BRCA1/2, первичная или интервальная циторедукция, полный или частичный эффект после платиносодержащей химиотерапии. Терапия олапарибом проводилась в дозе 300 мг 2 раза в сутки ежедневно до завершения 2-летнего периода терапии, по окончанию которого могло быть принято решение о продолжении терапии препаратом. Первичной конечной точкой исследования была выживаемость без прогрессирования (ВБП), вторичные конечные точки включали общую выживаемость (ОВ) и безопасность терапии. Статистическая обработка данных проводилась при помощи программного обеспечения R и RStudio.

Результаты и обсуждение

Результаты и обсуждение. Всего в исследование было включено 23 пациентки, медиана возраста которых составила 49 лет. У всех пациенток гистологический тип опухоли соответствовал серозной аденокарциноме высокой степени злокачественности, полная циторедукция была выполнена у 30% пациенток. С медианой наблюдения в 22 мес. медианы ВБП и ОВ не были достигнуты. Показатели 2-летней ВБП и ОВ составили 65 и 84% соответственно. В период применения препарата развитие нежелательных явлений 3-4-й степени было отмечено у 7 (30,4%) пациенток.

Заключение

Заключение. Результаты проведенного исследования демонстрируют высокую эффективность олапариба в реальной клинической практике и поддерживают результаты регистрационного исследования применения препарата при BRCA-ассоциированном РЯ после завершения первой линии противоопухолевой терапии.

Introduction

Introduction. Olaparib is the only PARP inhibitor approved in Russia for the maintenance therapy for BRCA-positive ovarian cancer after frontline chemotherapy. We conducted a real-world analysis of olaparib efficacy and safety for this indication.

Aim

Aim. To assess the efficacy of PARP inhibitors in real-world clinical practice.

Materials and methods

Materials and methods. Patients with stage III-IV BRCA-mutated ovarian cancer who received olaparib maintenance therapy in expanded access program in 03.2019-12.2020 timeframe. Briefly, key inclusion criteria were: serous or endometrioid highgrade ovarian cancer; pathogenic BRCA1/2 mutation; primary or interval debulking; complete or partial response to frontline platinum-based therapy. Olaparib was administered as tablets (300 mg BID) up to 2-years, disease progression or unacceptable toxicity, whichever occurred first. The primary endpoint of the study was progression-free survival (PFS), overall survival (OS) and safety were key secondary endpoints. Statistical analysis was done with R and RStudio software.

Results and discussion

Results and discussion. 23 patients were enrolled. Median age was 49 years, all patients had high-grade serous adenocarcinoma histology. Complete debulking at primary or interval surgery was achieved in 30% of patients. With median follow-up time equal to 22 months, median PFS and OS were not reached. The 2-year PFS and OS were 65 and 84%, respectively. Grade 3-4 adverse events was detected in 7 (30.4%) patients.

Conclusion

Conclusion. Our results supports high efficacy of olaparib in real clinical practice setting reported in the SOLO1 trial.

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The authors declare that there are no conflicts of interest present.