Objective: To compare real-world PFS between BEV and OLA as maintenance therapy for PSROC, with an exploratory evaluation of clinical outcomes after OLA dose reduction. Methods: This retrospective multicenter study included 101 patients with first platinum-sensitive recurrent ovarian, fallopian tube, or primary peritoneal cancer who achieved a response to platinum-based chemotherapy and then received maintenance therapy. Patients were classified into three groups: BEV (n = 34), standard-dose OLA (n = 31), and dose-reduced OLA (n = 36). The primary endpoint was PFS; secondary endpoints were OS and adverse events. Survival outcomes were evaluated using Kaplan–Meier methods and Cox proportional hazards models. Results: In the primary comparison of all OLA-treated patients versus BEV, OLA was associated with longer PFS (HR 0.48, 95% CI 0.29–0.77), with median PFS of 19 months versus 16 months, respectively. OS did not differ significantly between groups (HR 0.60, 95% CI 0.34–1.05). In exploratory subgroup analyses, patients who underwent OLA dose reduction had numerically longer PFS than those who remained on the full dose; however, this comparison is vulnerable to time-dependent and selection biases and should be interpreted cautiously. Grade ≥ 3 hematologic toxicities were more frequent in the OLA groups but were clinically manageable. Conclusions: In real-world practice, OLA was associated with longer PFS than BEV in PSROC. Clinically necessary dose reduction appeared feasible without an obvious loss of benefit, although this finding requires cautious interpretation.
Tatsuki et al. (Wed,) studied this question.