The forefront of ovarian cancer therapy: update on PARP inhibitors: Annals of Oncology

M.R. Mirza, R.L. Coleman, A. González-Martín, K.N. Moore, N. Colombo, I. Ray-Coquard, S. Pignata

Research output: Contribution to journalArticlepeer-review

Abstract

Background: In recurrent ovarian cancer, poly(ADP-ribose) polymerase (PARP)-inhibiting agents have transformed the treatment of platinum-sensitive disease. New data support use of PARP inhibitors earlier in the treatment algorithm. Design: We review results from recent phase III trials evaluating PARP inhibitors as treatment and/or maintenance therapy for patients with newly diagnosed ovarian cancer. We discuss the efficacy and safety of these agents in the all-comer and biomarker-selected populations studied in clinical trials, and compare the strengths and limitations of the various trial designs. We also consider priorities for future research, with a particular focus on patient selection and future regimens for populations with high unmet need. Results: Four phase III trials (SOLO-1, PAOLA-1/ENGOT-OV25, PRIMA/ENGOT-OV26 and VELIA/GOG-3005) demonstrated remarkable improvements in progression-free survival with PARP inhibitor therapy (olaparib, niraparib or veliparib) for newly diagnosed ovarian cancer. Differences in trial design (treatment and/or maintenance setting; single agent or combination; bevacizumab or no bevacizumab), patient selection (surgical outcome, biomarker eligibility, prognosis) and primary analysis population (intention-to-treat, BRCA mutated or homologous recombination deficiency positive) affect the conclusions that can be drawn from these trials. Overall survival data are pending and there is limited experience regarding long-term safety. Conclusions: PARP inhibitors play a pivotal role in the management of newly diagnosed ovarian cancer, which will affect subsequent treatment choices. Refinement of testing for patient selection and identification of regimens to treat populations that appear to benefit less from PARP inhibitors are a priority. © 2020 European Society for Medical Oncology
Original languageEnglish
Pages (from-to)1148-1159
Number of pages12
JournalAnn. Oncol.
Volume31
Issue number9
DOIs
Publication statusPublished - 2020

Keywords

  • niraparib
  • olaparib
  • ovarian cancer
  • PARP inhibitor
  • phase III
  • veliparib
  • antineoplastic agent
  • bevacizumab
  • nicotinamide adenine dinucleotide adenosine diphosphate ribosyltransferase inhibitor
  • placebo
  • anemia
  • asthenia
  • cancer prognosis
  • drug dose reduction
  • drug efficacy
  • drug safety
  • drug tolerability
  • drug withdrawal
  • fatigue
  • gene mutation
  • homologous recombination
  • human
  • maintenance therapy
  • neutropenia
  • oncogene
  • ovary cancer
  • overall survival
  • priority journal
  • progression free survival
  • Review
  • systemic therapy
  • thrombocytopenia
  • treatment duration
  • treatment outcome
  • tumor suppressor gene
  • female
  • genetics
  • ovary tumor
  • tumor recurrence
  • Carcinoma, Ovarian Epithelial
  • Female
  • Humans
  • Neoplasm Recurrence, Local
  • Ovarian Neoplasms
  • Poly(ADP-ribose) Polymerase Inhibitors

Fingerprint Dive into the research topics of 'The forefront of ovarian cancer therapy: update on PARP inhibitors: Annals of Oncology'. Together they form a unique fingerprint.

Cite this