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Debate 17A - When is the Best Time to Use PARP Inhibitors for Maintenance?

Front-line

from Section III - Ovarian Cancer

Published online by Cambridge University Press:  20 July 2023

By
Duaa H. Al-Rawi ,
Karen Cadoo  and
Roisin O’Cearbhaill
Edited by
Dennis S. Chi ,
Nisha Lakhi  and
Nicoletta Colombo
Dennis S. Chi
Affiliation:
Memorial Sloan-Kettering Cancer Center, New York
Nisha Lakhi
Affiliation:
Richmond University Medical Center, Staten Island
Nicoletta Colombo
Affiliation:
University of Milan-Bicocca
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Summary

The development and use of Poly(ADP-ribose) polymerase inhibitors (PARPi) in advanced ovarian cancer (OC) have been an incredible clinical breakthrough. PARPi are FDA-approved as front-line maintenance for BRCA1-/2- associated (olaparib or niraparib), homologous recombination deficient (HRD) (niraparib or olaparib with bevacizumab), and homologous recombination proficient (HRP) (niraparib) advanced-stage high-grade ovarian cancer (HGOC). Along with a third PARPi, rucaparib, they are also approved following recurrence as both maintenance and treatment. Here we advocate for PARPi as front-line maintenance for BRCA1-/2- associated (germline or somatic) and HRD tumors. We also discuss our recommendations for patients with HRP tumors.

Type
Chapter
Information
50 Big Debates in Gynecologic Oncology , pp. 95 - 97
Publisher: Cambridge University Press
Print publication year: 2023

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References

Moore, K, et al. Maintenance olaparib in patients with newly diagnosed advanced ovarian cancer. N Engl J Med 2018;379(26):2495–2505.CrossRefGoogle ScholarPubMed
Ray-Coquard, I, et al. Olaparib plus bevacizumab as first-line maintenance in ovarian cancer. N Engl J Med 2019;381(25):2416–2428.CrossRefGoogle ScholarPubMed
Gonzalez-Martin, A, et al. Niraparib in patients with newly diagnosed advanced ovarian cancer. N Engl J Med 2019;381(25):2391–2402.CrossRefGoogle ScholarPubMed
Poveda, A, et al. Olaparib tablets as maintenance therapy in patients with platinum-sensitive relapsed ovarian cancer and a BRCA1/2 mutation (SOLO2/ENGOT-Ov21): a final analysis of a double-blind, randomised, placebo-controlled, phase 3 trial. Lancet Oncol 2021;22(5):620–631.CrossRefGoogle Scholar
Moore, KN, et al. Niraparib monotherapy for late-line treatment of ovarian cancer (QUADRA): a multicentre, open-label, single-arm, phase 2 trial. Lancet Oncol 2019;20(5):636–648.CrossRefGoogle Scholar

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