Background: Nutritional status is an important factor influencing toxicity of treatment. Nutritional assessment indicators such as the Prognostic Nutritional Index (PNI), Controlling Nutritional Status (CONUT) score and modified Glasgow Prognostic Score (mGPS) have been reported to be associated with treatment-related adverse events (AEs) for various malignancies. However, there are no reports investigating the relationship between nutritional status and AEs from poly-(ADP-ribose) polymerase (PARP) inhibitors (PARPi), which are widely used in recent years as maintenance therapy for ovarian cancer. Objective: The primary objective was to investigate the usefulness of nutritional assessment indicators in predicting treatment discontinuation due to AEs from PARPi. Methods: This multicenter retrospective study included patients diagnosed with ovarian cancer who received maintenance therapy with PARPi from January 2018 to December 2023. PNI, CONUT score, and mGPS were calculated based on hematological parameters measured within 7 days before the start of PARPi therapy. Results: A total of 272 patients received maintenance therapy with PARPi during the period, but due to the absence of the blood collection of albumin levels within one week or other exclusion criteria, 71 patients were finally included in this analysis. AEs were seen in 59 patients (83.1%), including 25 (35.2%) severe events (grade ≥3 in Common Terminology Criteria for Adverse Events v5.0). Eighteen patients (25.4%) discontinued treatment due to PARPi-related AEs. Low PNI (<48.44) and high mGPS (≥1) were predictors of treatment discontinuation in both univariate and multivariate analyses. CONUT was not a significant predictor in this study. Conclusions: Our study suggested that PNI and mGPS can predict the risk of treatment discontinuation due to PARPi-related AEs before starting maintenance therapy. This insight opens avenues for more personalized treatment plans, potentially improving patient outcomes.
背景：营养状况是影响治疗毒性的重要因素。已有报道指出，预后营养指数（PNI）、控制营养状况（CONUT）评分及改良格拉斯哥预后评分（mGPS）等营养评估指标与多种恶性肿瘤治疗相关不良事件（AEs）存在关联。然而，目前尚无研究探讨营养状况与近年来广泛用于卵巢癌维持治疗的聚腺苷二磷酸核糖聚合酶（PARP）抑制剂（PARPi）所致不良事件之间的关系。目的：本研究主要旨在探讨营养评估指标在预测因PARPi相关不良事件导致治疗中止方面的应用价值。方法：这项多中心回顾性研究纳入了2018年1月至2023年12月期间接受PARPi维持治疗的卵巢癌患者。根据PARPi治疗开始前7天内测定的血液学参数计算PNI、CONUT评分和mGPS。结果：研究期间共有272例患者接受PARPi维持治疗，但因缺乏治疗前一周内白蛋白水平检测数据或其他排除标准，最终71例患者纳入分析。59例患者（83.1%）出现不良事件，其中25例（35.2%）为严重事件（依据不良事件通用术语标准5.0版分级≥3级）。18例患者（25.4%）因PARPi相关不良事件中止治疗。单因素和多因素分析均显示，低PNI（<48.44）和高mGPS（≥1）是治疗中止的预测因素，而CONUT评分在本研究中未显示显著预测价值。结论：本研究表明，在开始维持治疗前，PNI和mGPS可预测因PARPi相关不良事件导致治疗中止的风险。这一发现为制定更个体化的治疗方案提供了新思路，有望改善患者预后。
肿瘤(癌症)患者之家