Question

Describe key clinical trials of maintenance PARP inhibitor therapy in ovarian cancer in primary setting.

Hint:

Maintenance therapy with PARP inhibitors has become a cornerstone in the management of ovarian cancer, particularly for patients with BRCA mutations or HRD.

Answer 1

Poly(ADP-ribose) polymerase (PARP) inhibitors have shown significant efficacy in the treatment of ovarian cancer, particularly in patients with BRCA mutations or homologous recombination deficiency (HRD).
Step 1: Key Clinical Trials:
1. SOLO-1 Trial: This phase III trial evaluated the use of olaparib as a maintenance therapy in patients with BRCA1/2 mutations who had responded to first-line platinum-based chemotherapy. Results demonstrated improved progression-free survival (PFS) in patients receiving olaparib compared to placebo.
2. PRIMA Trial: This study assessed niraparib as maintenance therapy in patients with platinum-sensitive ovarian cancer, including both BRCA-mutated and non-mutated populations. Niraparib significantly improved PFS in patients with HRD, regardless of BRCA status.
3. VELIA Trial: The phase III VELIA trial evaluated veliparib in combination with chemotherapy and as a maintenance therapy. The results showed an improvement in PFS in patients with BRCA mutations.
Step 2: Implications for Treatment:
These trials have established the role of PARP inhibitors as an important component of maintenance therapy in ovarian cancer, particularly for those with BRCA mutations or HRD.