Discussion
neutropenia, toxicity, toxicities, anemia, platinum-sensitive
RECURRENCE, NEUTROPENIA, ANEMIA
The OPEB-01 study investigated triplet maintenance with olaparib, pembrolizumab, and bevacizumab in The recently presented MEDIOLA study showed the promising efficacy of a triplet combination (olaparib, durvalumab, and bevacizumab) as a treatment strategy for germline The efficacy of OPEB-01 can be compared to previous studies on currently available monotherapy options, namely PARP inhibitor and bevacizumab maintenance trials involving Furthermore, our efficacy outcome surpassed the median PFS of 18.9 months in the somatic The toxicity profile in our study was in line with that of previous studies. The most common AEs were hematologic toxicities, including anemia (any grade 38.6%; grade ≥ 3 22.7%) and neutropenia (any grade 38.6%; grade ≥ 3 6.8%). Both the toxicity rate and profile were similar to those in previous studies on olaparib monotherapy (anemia of any grade 16.9–46.0%; grade ≥ 3 5.1–21.0%; neutropenia of any grade 15.8–24.0%; grade ≥ 3 1.8–8.0%)In terms of AE-related statistics, our study had high dose reduction and interruption rates, 61.4% and 86.4% (for any of the three study drugs), respectively. These rates were higher than those reported in previous studies on doublet regimen. For instance, our dose interruption rate of 86.4% surpassed 54% in PAOLA-1In terms of activity, previous clinical studies have suggested that a triplet combination (PARP inhibitor, ICI, and antiangiogenic agent) may be more effective than a doublet combination (PARP inhibitor and ICI), especially in In addition to improving the efficacy, our data have suggested that triplet maintenance therapy may help expand the potential target population beyond Our study was limited by the fact that it was a single-arm, open-label study with a relatively small patient population and no comparator group. In terms of study design, we enrolled patients who had responded to second-line chemotherapy, making our cohort more favorable compared to previous studies where patients were enrolled regardless of their response to chemotherapy. Therefore, caution should be exercised when comparing our results with other maintenance trials, such as those involving bevacizumab, where the agent is administered concurrently with chemotherapy followed by maintenance, regardless of the response to chemotherapy. The 6-month PFS rate was chosen as the primary endpoint because this was a single-arm phase II study that evaluated signals for quick decision-making; based on previous randomized PARP inhibitor monotherapy trials, we expected that a majority of the patients would show recurrence within 6 months without maintenance therapy. However, it would be beneficial to have further survival maturation to determine whether the signals of durable responses translate into an overall survival benefit. Another limitation of our study is the small sample size, which was especially limiting for subgroup analysis of PFS concerning HRD or PD-L1 status. Additionally, we lacked an olaparib or bevacizumab monotherapy group as a comparator. Hence, a future randomized trial with triplet maintenance may be necessary. With these limitations in mind, the strength of our study is the homogenous patient population in a platinum-sensitive recurrent setting. All patients were screened for germline and somatic In conclusion, findings from the OPEB-01 study show that the triplet maintenance therapy with olaparib, pembrolizumab, and bevacizumab leads to promising outcomes and is tolerable in 