Background: Niraparib, a PARP inhibitor, is approved in the UK as a maintenance monotherapy for advanced ovarian cancer (aOC) following a response to first-line platinum-based chemotherapy. The PRIMA study demonstrated a significant improvement in progression-free survival (PFS) in patients receiving maintenance niraparib compared to placebo. We conducted a retrospective study to assess its efficacy in real life. Method: We retrospectively collected data on patients with newly diagnosed aOC, who had a response following platinum-based chemotherapy, irrespective of BRCA or HRD status.Results: From February 2021 to June 2024, data were collected from 49 patients newly diagnosed with aOC treated at a tertiary cancer center in the North East of England. Baseline characteristics (table 1) showed that out of 49 patients, 38 patients with prior surgery, 16 had interval debulking and 22 had upfront surgery; 87%(14/16) and 95%(21/22) had no residual disease, respectively. 9 (18%) patients had tumors with homologous-recombination deficiency. Mean niraparib dose at treatment initiation was 200 mg/day. Niraparib was discontinued in 26/49 patients (due to adverse events [AEs], n=2; disease progression, n=24). treatment-related AEs occurred in 43/49 patients, most commonly constipation (26%of patients), hypertension (24%) nausea (22%) thrombocytopenia (16%), and anaemia (10%). One patient reported depression. The median overall survival was 21.3 months and was similar regardless of HRD status.  Median progression-free survival was 17.7 months overall, with HRD-positive patients experiencing a longer median progression-free survival of 20.4 months compared to 15 months in HRD-negative patients.Conclusion: Our analysis demonstrates that Niraparib as first-line maintenance therapy improves progression-free survival in patients with aOC, consistent with the findings of the PRIMA trial. Furthermore, Niraparib has a manageable safety profile, making it a valuable treatment option for this patient population.

Ahmed Shaheen earned his MBBS from Thamar University. He continued his medical training in the UK and is currently undergoing medical oncology training at the Northern Centre for Cancer Care. He also completed a PgCert in medical education from the University of Sunderland and has published several papers in reputable journals.