SGO Practice Statement: PARP Inhibitor Maintenance Therapy for Ovarian Cancer
Posted: Wednesday, September 9, 2020
To help oncology clinicians make appropriate evidence-based decisions regarding the use of front-line PARP inhibitor maintenance therapy for women with ovarian cancer, the Society of Gynecologic Oncology (SGO) recently issued a practice statement. Published in Gynecologic Oncology, the practice statement is based on data from four randomized phase III trials—SOLO-1, PRIMA, VELIA, and PAOLA-1—featuring the three PARP inhibitors approved by the U.S. Food and Drug Administration in ovarian cancer: olaparib, niraparib, and rucaparib.
“The recent data from four randomized phase III trials have established an important role for front-line PARP inhibitor maintenance therapy and highlight the importance of universal germline and tumor BRCA-mutant testing in ovarian cancer,” commented Bhavana Pothuri, MD, of NYU School of Medicine, New York, and colleagues.
Based on the results of these major clinical trials, improvement in progression-free survival was demonstrated in the cohort of patients with homologous recombination–deficient (HRD) disease, but to a lesser degree than in patients with BRCA-mutant ovarian cancer. According to secondary analyses, PARP inhibitors yielded a “more limited” overall impact in patients with homologous recombination–proficient disease. As for overall survival outcomes, at the time of publication, data for this secondary endpoint were not yet mature. In terms of safety, the most commonly reported adverse events with PARP inhibitors in these clinical trials were fatigue, hematologic adverse events, and gastrointestinal toxicity.
According to the investigators, several unanswered questions remain. They center on when to use combination therapy with bevacizumab, the role HRD testing will play in the future, the optimal treatment of patients with homologous recombination–proficient disease, and balancing cost/benefit of treatment.
Disclosure: For full disclosures of the study authors, visit sciencedirect.com.