Real-world monitoring and clinical management of decreased platelet counts in patients with epithelial ovarian cancer who received first-line maintenance niraparib in the ACTIV1ZE study.
Publication Title
Gynecologic oncology
Document Type
Article
Publication Date
6-1-2026
Keywords
Humans; Female; Indazoles; Carcinoma, Ovarian Epithelial; Ovarian Neoplasms; Piperidines; Retrospective Studies; Platelet Count; Poly(ADP-ribose) Polymerase Inhibitors; Middle Aged; Thrombocytopenia; Aged; Maintenance Chemotherapy; Adult; Cohort Studies; Decreased platelet counts; Epithelial ovarian cancer; First-line maintenance; Niraparib; Real-world clinical management; Real-world monitoring.; washington; seattle; swedish cancer
Abstract
OBJECTIVE: To describe the frequency of platelet count testing and decreased platelet counts (DPCs), time to onset and resolution of DPCs, and clinical management of DPCs among patients with epithelial ovarian cancer (EOC) who received first-line maintenance (1LM) niraparib monotherapy.
METHODS: This retrospective US-based cohort study included adults with EOC who had a platelet count of ≥100,000/μL at 1LM niraparib monotherapy initiation (April 1, 2020-June 3, 2023). Platelet count testing patterns were described and patients grouped for any-grade DPC, grade ≥3 DPC, or no DPC. Timings of DPC onset and resolution were estimated and niraparib clinical management strategies (ie, dose modifications) and the frequency, timing of, and reasons for niraparib discontinuation were described.
RESULTS: Among 543 eligible patients, most received frequent platelet count tests; for those who experienced DPCs (≈37% any-grade, ≈22% grade ≥3), onset was usually early (≤1 month after 1LM niraparib initiation), with ≥98.0% of cases resolving, with a median time to resolution of ≈2 weeks. Aligning with management guidelines, most patients received dose modifications during first DPC, and most continued treatment (≈84%). Most patients who discontinued treatment during first DPC did not receive dose modification prior to discontinuation.
CONCLUSIONS: In this real-world setting of patients with EOC prescribed 1LM niraparib, DPCs usually occurred early, were quickly resolved for nearly all patients, and were generally managed with dose modifications, resulting in low discontinuation rates. However, dose modifications were absent in most patients who discontinued, highlighting an opportunity to improve clinical management strategies to support treatment continuation, thereby potentially optimizing patient benefit.
Area of Special Interest
Cancer
Area of Special Interest
Women & Children
Specialty/Research Institute
Oncology
Specialty/Research Institute
Pharmacy
Specialty/Research Institute
Obstetrics & Gynecology
DOI
10.1016/j.ygyno.2026.04.012
