PARP Inhibitor Combinations and Future of Ovarian Cancer

Matthew A. Powell, MD:The exciting combinations out there, I think, initially stem from the olaparib/cediranib discussion, where you have an antivascular agent combined with a PARP inhibitor, seeing very nice response rates and progression-free survival benefits both in aBRCApopulation and a wild type population. This has been built upon now with olaparib/bevacizumab. We have some early signals that there’s nice, maybe even synergistic-type, effects. As mentioned earlier, the TOPACIO trial looking at niraparib plus a PD-1 inhibitor—the immunotherapies combined with PARP inhibitors—also seems to be very exciting. I imagine we’ll see all 3 of those agents combined where we have antivascular, PD, and PARP. Again, drugs with cross-resistant toxicities that likely can be combined in a nonchemotherapy fashion, all targeted therapy. I think these may be very nice noncytotoxic chemotherapy options that we have to offer our patients.

I’m very excited at this time for our patients with ovarian cancer. We have a lot of options. These combinations are quite exciting. I think the antibody—drug conjugates also are coming into play, and perhaps combining these with immunotherapy agents, with PARP agents also, is going to be 1 more part of our armamentarium. When to use these drugs—we still need to investigate that. As we mentioned, some of the up-front trials now, first-line maintenance strategies: Is that the right place to put these agents? We don’t know yet, and I think that it’s very exciting to see some of these data come out. I think ASCO 2018 is going to shed a lot of light on some new therapies we have for our patients and I hope help more and more patients with ovarian cancer.

Transcript edited for clarity.