ARIEL3 Trial Update on Rucaparib Maintenance for Recurrent Ovarian Cancer
Posted: Monday, July 6, 2020
According to Robert L. Coleman, MD, of The University of Texas MD Anderson Cancer Center, Houston, and colleagues, patients with recurrent ovarian cancer appear to derive a durable clinical benefit from maintenance treatment with rucaparib after disease progression. The updated findings of the phase III ARIEL3 trial, which were published in The Lancet Oncology, indicated that treatment with the PARP inhibitor may delay the initiation of additional anticancer therapies.
“As management of ovarian cancer evolves to incorporate strategies such as maintenance, it is important to understand how such treatments influence the post-progression survival of patients,” the investigators commented. “Our analyses suggest that rucaparib maintenance does not negatively affect the efficacy of subsequent treatments.”
A total of 564 patients with a platinum-sensitive serous or endometrioid ovarian, primary peritoneal, or fallopian tube carcinoma were randomly assigned in a 2:1 ratio to receive either rucaparib or a placebo in 28-day cycles. All patients underwent at least two prior platinum-based chemotherapy regimens and experienced disease progression for at least 6 months. Follow-up data were provided for an average of 28.1 months.
The median chemotherapy-free interval in the experimental and control groups was 14.3 versus 8.8 months, respectively. The investigators reported an increased median time to the start of the first subsequent therapy in the experimental group, compared with the control group (12.4 vs. 7.2 months). The median time to disease progression or death on subsequent therapy appeared to be significantly longer in the experimental group than in the control group (21.0 vs. 16.5 months, P = .0002). The median time to the start of second subsequent therapy in the experimental and control groups was 22.4 versus 17.3 months, respectively (P = .0007). Overall, patients with BRCA mutations or homologous recombination deficiencies in the experimental group experienced similar outcomes. The updated safety profile appeared to be congruent with previous reports.
Disclosure: For full disclosures of the study authors, visit thelancet.com.
