Bradley Monk, MD, FACOG, FACS, clinician at Arizona Oncology, discusses the ovarian cancer patients most likely to respond well to PARP inhibition.
Bradley Monk, MD, FACOG, FACS, professor at the University of Arizona and Creighton University in Phoenix and clinician at Arizona Oncology, discusses the ovarian cancer patients most likely to respond well to PARP inhibition.
In your experience, who are the patients who fare best with PARP inhibitors for ovarian cancer?
The first randomized trials to show efficacy of PARP inhibitors were these 3 maintenance treatments in recurrent ovarian cancer, and olaparib has 2 studies, Study 19 and SOLO2; niraparib of has one, NOVA; and then rucaparib has 1, ARIEL3. And so you can now use PARP inhibitors in treatment in recurrent ovarian cancer based on level 1 randomized trial data, if the patient responds to platinum, across all biomarker subgroups, because response to platinum in the recurrent setting is the biomarker. So again, if you treat a patient in platinum-sensitive relapse with carboplatin-paclitaxel, or carboplatin-liposomal doxorubicin, or even carboplatin-gemcitabine, if she responds, you can keep her in response with either olaparib, rucaparib, or niraparib without sort of ruining the patient experience. All of those studies have no decrement in patient reported outcomes, and no new safety signals identified.