ArticleJournal of gynecologic oncology2026
Effect of first-line poly(ADP-ribose) polymerase inhibitor on second-line platinum-based chemotherapy in epithelial ovarian cancer.
Article in Journal of gynecologic oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveResearch on platinum sensitivity after poly(ADP-ribose) polymerase (PARP) inhibitor administration, which offers prognostic benefits for first-line treatment of advanced epithelial ovarian cancer (EOC), is limited. Here, we evaluated the impact of first-line maintenance therapy with PARP inhibitors on the efficacy of second-line platinum-based chemotherapy in patients with advanced EOC.
methodsWe retrospectively analyzed 100 patients with platinum-sensitive recurrent EOC who received second-line platinum-based chemotherapy between 2015 and 2024. The PARP inhibitor group included 35 patients who received PARP inhibitors as first-line maintenance, whereas the control group included 65 patients who did not. Overall response rate, post-recurrence progression-free survival (PFS), and post-recurrence overall survival (OS) were compared between the groups. Subgroup analyses were conducted using homologous recombination deficiency status and platinum-free interval (PFI).
resultsThe overall response rate was significantly lower in the PARP inhibitor group (25.7%) compared with the control group (89.2%, p<0.001). Median post-recurrence PFS and OS were significantly shorter in the PARP inhibitor group compared to that in the control group. In the PARP inhibitor group, homologous recombination deficiency-positive patients did not show better outcomes than homologous recombination deficiency-negative patients. Moreover, the overall response rate for patients with 6-12 months PFI was particularly poor in the PARP inhibitor group.
conclusionFirst-line PARP inhibitor maintenance therapy may reduce the efficacy of subsequent platinum-based chemotherapy, potentially inducing platinum resistance. These findings highlight the need to reconsider treatment strategies and predictive biomarkers for second-line therapy following PARP inhibitor exposure in relapsed EOC.
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