An Abundance of PARP Inhibitors are Changing Ovarian Cancer Treatment

Ursula A. Matulonis, MD, chief of the Division of Gynecologic Oncology at the Dana-Farber Cancer Institute, discusses how PARP inhibitors have impacted the treatment of ovarian cancer worldwide.

Three PARP inhibitors are currently approved for ovarian cancer treatment including, niraparib (Zejula), olaparib (Lynparza), and rucaparib (Rubraca). These 3 agents often overlap in regard to FDA approval, specifically in the recurrent, platinum-sensitive setting, as all 3 have identical approvals as a maintenance therapy after chemotherapy.

If the patient's cancer is in response to platinum-based chemotherapy and a recurrent disease, they can use a PARP inhibitor as maintenance therapy post chemotherapy. Once reports show them to be in remission and have higher blood count levels, 1 of the 3 PARP inhibitors can be given as maintenance until either toxicities occur or progression of the disease.

In the recurrent setting for these 3 PARP inhibitors, other FDA approvals exist as all 3 of these inhibitors have approvals as treatment for BRCA mutated, heavily pretreated ovarian cancer.

Transcription:

0:08 | Currently, at least in the United States and certainly increasingly worldwide, there are 3 PARP inhibitors that are FDA approved for ovarian cancer, and those are niraparib, olaparib, and rucaparib. In this situation for patients with recurrent platinum-sensitive ovarian cancer in the maintenance setting, often your PARP inhibitors have essentially overlapping and identical FDA approval. As long as the patient's cancer is in response to platinum-based chemotherapy, she has recurrent disease, she can use a PARP inhibitor as maintenance therapy post chemotherapy. Once her blood counts come back up and she's in remission, she can receive one of those 3 PARP inhibitors as maintenance, and that's until either toxicities or progression.

1:06 | Unlike in the patients with newly-diagnosed cancer, where there's a set point of 2 years in the recurrent population in the NOVA, SOLO2 [NCT01874353], and ARIEL3 [NCT01968213] trials, patients continue on PARP inhibitors until progression or toxicities. There are other FDA approvals in the recurrent setting for each of these 3 PARP inhibitors and that's as standalone treatment for more heavily pretreated BRCA mutated ovarian cancer and niraparib has the additional approval of an HRD cancer that's platinum sensitive.