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Turinetto M, Ricotti A, Marchetti C, Pisano C, Zamagni C, Cassani C, Malaguti P, Baldoni A, Scollo P, Scandurra G, Parisi A, Artioli G, Palaia I, Vertechy L, Bergamini A, Picardo E, Tuninetti V, Scotto G, Scambia G, Pignata S, Valabrega G. MITO39: Efficacy and Tolerability of Pegylated Liposomal Doxorubicin (PLD)-Trabectedin in the Treatment of Relapsed Ovarian Cancer after Maintenance Therapy with PARP Inhibitors-A Multicenter Italian Trial in Ovarian Cancer Observational Case-Control Study. Cancers (Basel) 2023; 16:41. [PMID: 38201470 PMCID: PMC10778130 DOI: 10.3390/cancers16010041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 11/24/2023] [Accepted: 12/11/2023] [Indexed: 01/12/2024] Open
Abstract
OBJECTIVE While PLD-Trabectedin is an approved treatment for relapsed platinum-sensitive ovarian cancer, its efficacy and tolerability has so far not been tested extensively in patients who progress after poly ADP-ribose polymerase inhibitor (PARPi) treatment. METHODOLOGY This multicenter, retrospective analysis had the objective of comparing patients receiving PLD-Trabectedin after being treated with PARP-I (cases) with PARPi-naïve patients. Descriptive and survival analyses were performed for each group. RESULTS Data from 166 patients were collected, composed of 109 cases and 57 controls. In total, 135 patients were included in our analyses, composing 46 controls and 89 cases. The median PFS was 11 months (95% IC 10-12) in the control group vs. 8 months (95% IC 6-9) in the case group (p value 0.0017). The clinical benefit rate was evaluated, with an HR for progression of 2.55 (1.28-5.06) for the case group (p value 0.008), persisting when adjusted for BRCA and line with treatment. We compared hematological toxicity, gastro-intestinal toxicity, hand-foot syndrome (HFS), fatigue, and liver toxicity, and no statistically significant disparity was noted, except for HFS with a p value of 0.006. The distribution of G3 and G4 toxicities was also equally represented. CONCLUSION The MITO39 study showed a statistically significant difference in terms of PFS, suggesting that previous exposure to PARPi might inhibit the efficacy of PLD-Trabectedin. Regarding tolerability, no remarkable disparity was noted; PLD-Trabectedin was confirmed to be a well-tolerated scheme in both groups. To our knowledge, these are the first data regarding this topic, which we deem to be of great relevance in the current landscape.
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Affiliation(s)
| | - Andrea Ricotti
- Clinical Trial, Ordine Mauriziano Hospital, 10128 Turin, Italy;
| | - Claudia Marchetti
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (C.M.); (L.V.); (G.S.)
| | - Carmela Pisano
- Department of Urology and Gynecology, National Cancer Institute IRCCS Fondazione G. Pascale, 80131 Naples, Italy; (C.P.); (S.P.)
| | - Claudio Zamagni
- Addarii Medical Oncology, Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS), Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy;
| | - Chiara Cassani
- Unit of Obstetrics and Gynecology, IRCCS Matteo Foundation, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy;
| | - Paola Malaguti
- Medical Oncology 1, Regina Elena National Cancer Institute–IRCCS, 00144 Rome, Italy;
| | - Alessandra Baldoni
- Oncology and Hematology Department, Mirano AULSS3 Serenissima, 30035 Mirano, Italy;
| | - Paolo Scollo
- Division of Gynecology and Obstetrics, Maternal and Child Department, Cannizzaro Hospital, Kore University Enna, 94100 Enna, Italy;
| | | | - Alessandro Parisi
- Clinica Oncologica e Centro Regionale di Genetica Oncologica, Azienda Ospedaliero-Universitaria delle Marche, Università Politecnica delle Marche, 60126 Ancona, Italy;
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy
| | - Grazia Artioli
- Oncology Department, Ca’ Foncello Hospital, 31100 Treviso, Italy;
| | - Innocenza Palaia
- Department of Obstetrics and Gynecology, Sapienza University, 00185 Rome, Italy;
| | - Laura Vertechy
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (C.M.); (L.V.); (G.S.)
| | - Alice Bergamini
- Department of Gynaecology and Obstetrics, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, 20132 Milan, Italy;
| | - Elisa Picardo
- Obstetrics and Gynaecology 4, Sant’Anna Hospital, AOU Città della Salute e della Scienza of Turin, 88100 Turin, Italy;
| | | | - Giulia Scotto
- Department of Oncology, University of Turin, 10124 Turin, Italy; (G.S.); (G.V.)
| | - Giovanni Scambia
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (C.M.); (L.V.); (G.S.)
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Sandro Pignata
- Department of Urology and Gynecology, National Cancer Institute IRCCS Fondazione G. Pascale, 80131 Naples, Italy; (C.P.); (S.P.)
| | - Giorgio Valabrega
- Department of Oncology, University of Turin, 10124 Turin, Italy; (G.S.); (G.V.)
- Medical Oncology, Ordine Mauriziano Hospital, 10128 Turin, Italy;
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