First-Line Maintenance Therapy Patterns in BRCA Wild-Type, HRD-Negative or Biomarker-Unknown Advanced Epithelial Ovarian Cancer: A Five-Country European Real-World Study by APLUSA.

Simple Summary: Many women with advanced epithelial ovarian cancer do not have a biomarker to guide treatment decisions after initial chemotherapy. In this situation, doctors may choose different post-chemotherapy strategies depending on patient factors, local practice and national access to medicin...

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Publicado en:Cancers Vol. 18; no. 16; pp. 2682 - 2695
Autores principales: Uccello, Mario, Boussios, Stergios, Maï, Christine, Worton, Hilary, Bazire, Arthur, de Buhren, Bertrand
Formato: research tables/charts Journal Article
Publicado: MDPI Aug2026
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Aug2026
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      pub: MDPI
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        196664972
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        10.3390/cancers18162682
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        atl: First-Line Maintenance Therapy Patterns in BRCA Wild-Type, HRD-Negative or Biomarker-Unknown Advanced Epithelial Ovarian Cancer: A Five-Country European Real-World Study by APLUSA.
      aug:
        au:
          Uccello, Mario
          Boussios, Stergios
          Maï, Christine
          Worton, Hilary
          Bazire, Arthur
          de Buhren, Bertrand
        affil: Department of Oncology, Royal United Hospitals Bath NHS Foundation Trust, Bath BA1 3NG, UK
      sug:
        subj:
          Genes, BRCA
          Tumor Markers, Biological
          Carcinoma, Ovarian Epithelial Therapy
          Ovarian Neoplasms Therapy
          Bevacizumab Therapeutic Use
          Poly(ADP-Ribose) Polymerase Inhibitors Therapeutic Use
          Disease Surveillance
          Human
          Mutation
          France
          Germany
          Spain
          United Kingdom
          Europe
          Neoplasm Staging
          Chemotherapy, Cancer
          Multiple Logistic Regression
          Disease Attributes
          Descriptive Statistics
          Chi Square Test
          Exploratory Research
          Funding Source
      ab: Simple Summary: Many women with advanced epithelial ovarian cancer do not have a biomarker to guide treatment decisions after initial chemotherapy. In this situation, doctors may choose different post-chemotherapy strategies depending on patient factors, local practice and national access to medicines. This study looked at real-world treatment choices in France, Germany, Italy, Spain and the United Kingdom for patients without a known biomarker result supporting a specific targeted maintenance approach. The aim was to describe how often different strategies were used and whether choices differed between countries after accounting for patient and disease characteristics. The findings show substantial variation between countries, which may partly reflect differences in national access, reimbursement and clinical practice. These results may help guide future outcome-based studies comparing post-chemotherapy strategies in patients without a biomarker to direct maintenance treatment. Background/Objectives: First-line maintenance is established in advanced epithelial ovarian cancer (AEOC), but management remains uncertain for patients without a BRCA mutation or homologous recombination deficiency (HRD)-positive disease. We assessed real-world use of bevacizumab, poly(ADP-ribose) polymerase (PARP) inhibitors and active surveillance in France (FR), Germany (DE), Italy (IT), Spain (ES) and the United Kingdom (UK). Methods: Anonymised physician-reported charts were analysed from a retrospective, non-interventional online survey conducted by AplusA Healthcare Marketing Research. Eligible patients had stage III–IV AEOC, no known BRCA-mutated or HRD-positive disease, no progression after first-line platinum chemotherapy, and started maintenance therapy or active surveillance between November 2024 and March 2026. Treatment allocation was compared by chi-square testing. Multinomial logistic regression assessed whether country remained associated with strategy after adjustment for clinical and disease characteristics. Results: Among 3293 patients, 1295 (39.3%) received bevacizumab, 1087 (33.0%) niraparib, 158 (4.8%) rucaparib, 477 (14.5%) active surveillance and 276 (8.4%) other therapy. Treatment allocation differed by country (χ2 = 725.4, df = 16, p < 0.001). Bevacizumab was most frequent in FR and least frequent in the UK; niraparib was most frequent in ES and the UK; active surveillance was most common in the UK and IT. In the adjusted model, country was the strongest factor associated with strategy (likelihood-ratio χ2 = 550.1, df = 8, p < 0.001). Conclusions: First-line maintenance practice in AEOC without an actionable BRCA/HRD biomarker varies substantially across European countries. These differences may partly reflect national access, reimbursement, clinical practice and other unmeasured country-level factors. Outcome-based real-world studies are needed to clarify the best strategy.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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