聚（ADP-核糖）聚合酶抑制剂维持治疗的疾病复发模式尚不清楚，可能会影响后续治疗。这项 3 期 PRIMA/ENGOT-OV26/GOG-3012 研究的特别亚组分析评估了晚期卵巢癌 (AOC) 患者的初始复发模式。PRIMA 包括疾病进展高风险的参与者。这项临时分析仅评估了随机接受尼拉帕尼维持治疗的参与者，基线时没有疾病证据。评估了研究者评估的进展性疾病 (PD) 时初始复发病灶的数量和部位。 在分析的 314 名尼拉帕尼治疗患者中，190 名出现≥1 个新病灶（新病灶中位数为 1.0；四分位数范围， 1-2）。总共，93.2% (177/190) 的患者在首次疾病进展时出现 1-3 个病变。最常见的复发部位是腹膜（30.0% [57/190]）、淋巴结（26.3% [50/190]）和肝脏（20.5% [39/190]）。当 PD 患者根据生物标志物状态、诊断时的疾病阶段和减瘤手术类型进行分层时，观察到了类似的结果。具有同源重组能力的肿瘤、III期疾病或有原发性减瘤史的患者在第一次进展时出现中位2.0个新病灶；患有同源重组缺陷型肿瘤、IV 期疾病或有间隔减瘤史的患者中出现新病灶的中位数为 1.0。许多在一线维持治疗开始时没有病灶的 AOC 患者在首次复发时出现寡转移病。需要进行前瞻性评估，以确定当局部治疗与持续、系统、靶向维持治疗相结合时，这些患者的预后是否有所改善。版权所有 © 2024。由 Elsevier Inc. 出版。

Patterns of disease recurrence on poly(ADP-ribose) polymerase inhibitor maintenance therapy are unclear and may affect subsequent treatment. This ad hoc subgroup analysis of the phase 3 PRIMA/ENGOT-OV26/GOG-3012 study evaluated patterns of initial recurrence in patients with advanced ovarian cancer (AOC).PRIMA included participants at high risk for disease progression. This ad hoc analysis only evaluated participants randomized to niraparib maintenance without evidence of disease at baseline. The number and site(s) of initial recurrent lesions at investigator-assessed progressive disease (PD) were evaluated.Of the 314 niraparib-treated patients analyzed, 190 developed ≥1 new lesion (median number of new lesions, 1.0; interquartile range, 1-2). In total, 93.2% (177/190) of patients developed 1-3 lesions at first disease progression. The most common sites of recurrence were the peritoneum (30.0% [57/190]), lymph nodes (26.3% [50/190]), and liver (20.5% [39/190]). Similar results were observed when patients with PD were stratified by biomarker status, disease stage at diagnosis, and type of debulking surgery. Patients with homologous recombination-proficient tumors, stage III disease, or a history of primary debulking developed a median of 2.0 new lesions at first progression; patients with homologous recombination-deficient tumors, stage IV disease, or a history of interval debulking developed a median of 1.0 new lesion.Many patients with AOC without lesions at first-line maintenance treatment initiation develop oligometastatic disease at first recurrence. Prospective evaluation is required to determine whether these patients have improved outcomes when local therapies are combined with continuous, systemic, targeted maintenance therapy.Copyright © 2024. Published by Elsevier Inc.