Treatment patterns and BRCA testing practices in platinum-sensitive recurrent serous ovarian cancer: a Spanish medical record review

Abstract

Background: Platinum-based chemotherapy is considered standard treatment for platinum-sensitive recurrent ovarian cancer (PSR OC). Real-world data on BRCA mutation (BRCAm) testing, treatment patterns and characteristics of patients ( pts) diagnosed with PSR OC will help to identify unmet medical needs in this population. Methods: We retrospectively reviewed a random sample of medical records of women having serous PSR OC after 1st-line platinum completion, during 2009-2013, to assess PSR OC treatment patterns and BRCAm testing. Study index date was defined as PSR OC diagnosis date. Results: Data from 298 pts were collected in Spain. At diagnosis,median age: 58 years; ECOG 0, 1: 38%, 52%; advanced disease stage (≥IIb): 93%; high grade: 80%. Primary tumour sites: ovary (88%); fallopian tube (8%); primary peritoneum (4%). 70% of pts had received primary cytoreductive surgery, 88% received carboplatin + paclitaxel as 1st-line (with or without bevacizumab) (median number of cycles 6) and 4% received intraperitoneal treatment. 7% of pts receivedmaintenance therapy after 1st-line,mainly bevacizumab (95%). The majority of pts (78%) received 2nd-line therapy: platinum based 91%;mainly carboplatin + paclitaxel (31%), gemcitabine (15%) or pegylated liposomal doxorubicin (9%); 20% concomitant bevacizumab. Median times frominitial ovarian cancer diagnosis to index date and fromindex date to end of follow-up were 20 months. BRCA testing was performed in 83 (28%) of pts and 76 (92%) had a conclusive result available. Of those, 34% were BRCAm. 16% of total pts (69% of BRCAmpts) had family history of BRCA-related cancer (breast 81%; ovarian 41%). BRCA tests were performed on blood (76%) and tumour tissue (24%) samples. BRCA testing method unknown: 65%. When known, directDNA sequencing was themost used BRCA testingmethod (16 pts, 55%). Conclusions: Platinum-based chemotherapy for PSR OC was the standard of care in this review. Bevacizumab was associated with chemotherapy in only 20% of pts. Family history of BRCA related cancer was absent in 31% of BRCAm pts. BRCA testing was not routinely performed. Physicians were mostly unfamiliar with the BRCA testing method used; when known, direct DNA sequencing was the most commonly used method.