Treatment Patterns in Epithelial Ovarian Cancer (EOC) With a Focus on Recurrent EOC and PARPi Progressors: A Targeted Literature Review Across Selected Countries
Author(s)
Jukka Montonen, PhD1, Mehul Chourasia, PhD2, Aurore Bergamasco, PharmD, MSc3, Teigna Arredondo Bisono, MSc3, Victoria Munoz Goyette, MSc4, Yola Moride, PhD5.
1Merck Healthcare KGaA, Darmstadt, Germany, 2Merck Specialities Pvt Ltd, Bangalore, India, an affiliate of Merck KGaA, Darmstadt, Germany, 3YolaRx Consultants, Paris, France, 4YolaRx Consultants, Montreal, QC, Canada, 5Rutgers University PETS, New Brunswick, NJ, USA.
1Merck Healthcare KGaA, Darmstadt, Germany, 2Merck Specialities Pvt Ltd, Bangalore, India, an affiliate of Merck KGaA, Darmstadt, Germany, 3YolaRx Consultants, Paris, France, 4YolaRx Consultants, Montreal, QC, Canada, 5Rutgers University PETS, New Brunswick, NJ, USA.
OBJECTIVES: Epithelial ovarian cancer (EOC) remains the most lethal gynecologic malignancy, often diagnosed at advanced stages. Understanding real-world treatment patterns across regions is critical for optimizing patient management. This review examined treatment patterns in the United States (US), Europe, China and Japan, focusing on recurrent EOC and patients with disease progression on poly (ADP-ribose) polymerase inhibitors (PARPi).
METHODS: A targeted literature review was conducted following the PICOTS framework. A structured literature search in Ovid® MEDLINE and Embase (January 1, 2014-June 18, 2024) was supplemented by pragmatic searches and citation snowballing.
RESULTS: Eighteen eligible studies were included (US [n=6], France [n=2], Greece [n=2], Denmark [n=1], the Netherlands [n=1], the UK [n=1], Japan [n=3], and China [n=2]). Surgery and chemotherapy were the most reported treatment modalities in patients with EOC, with surgery rates ranging from 73.5% (US) to 100% (Japan). Chemotherapy was widely used, particularly in patients with advanced-stage EOC. A SEER 18 registry study (US) reported a decline in surgical rates (93.5% in 1990-1994 vs. 91.8% in 2010-2014; p<0.001) and increased chemotherapy use (67.4% to 75.0%). In the Netherlands, a shift was observed from primary to interval debulking surgery. Most patients with recurrent EOC received alternative platinum-based chemotherapy with best supportive care or radiotherapy (66-90% in three studies from Europe and Japan). Real-world data on patients with disease progression on PARPi were scarce. A single-center Chinese study reported that chemotherapy (72.6%, 51.0% platinum-based and 21.6% non-platinum) was predominant treatment for patients with disease progression on PARPi, followed by a second PARPi in combination with antiangiogenic therapy (17.6%).
CONCLUSIONS: Despite shared trends in EOC treatment patterns across countries, significant real-world evidence gaps persist, particularly for recurrent EOC and post-maintenance strategies following PARPi. An updated review with a systematic approach is required to inform decision-making to optimize patient management.
METHODS: A targeted literature review was conducted following the PICOTS framework. A structured literature search in Ovid® MEDLINE and Embase (January 1, 2014-June 18, 2024) was supplemented by pragmatic searches and citation snowballing.
RESULTS: Eighteen eligible studies were included (US [n=6], France [n=2], Greece [n=2], Denmark [n=1], the Netherlands [n=1], the UK [n=1], Japan [n=3], and China [n=2]). Surgery and chemotherapy were the most reported treatment modalities in patients with EOC, with surgery rates ranging from 73.5% (US) to 100% (Japan). Chemotherapy was widely used, particularly in patients with advanced-stage EOC. A SEER 18 registry study (US) reported a decline in surgical rates (93.5% in 1990-1994 vs. 91.8% in 2010-2014; p<0.001) and increased chemotherapy use (67.4% to 75.0%). In the Netherlands, a shift was observed from primary to interval debulking surgery. Most patients with recurrent EOC received alternative platinum-based chemotherapy with best supportive care or radiotherapy (66-90% in three studies from Europe and Japan). Real-world data on patients with disease progression on PARPi were scarce. A single-center Chinese study reported that chemotherapy (72.6%, 51.0% platinum-based and 21.6% non-platinum) was predominant treatment for patients with disease progression on PARPi, followed by a second PARPi in combination with antiangiogenic therapy (17.6%).
CONCLUSIONS: Despite shared trends in EOC treatment patterns across countries, significant real-world evidence gaps persist, particularly for recurrent EOC and post-maintenance strategies following PARPi. An updated review with a systematic approach is required to inform decision-making to optimize patient management.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EPH258
Topic
Epidemiology & Public Health, Health Service Delivery & Process of Care
Topic Subcategory
Safety & Pharmacoepidemiology
Disease
Oncology