Dr. Penson on the Eligibility Criteria for PARP Inhibitors in Advanced Ovarian Cancer

Richard T. Penson, MD, MRCP
Published: Tuesday, Feb 25, 2020



Richard T. Penson, MD, MRCP, associate professor of medicine, Harvard Medical School, and clinical director of Medical Gynecologic Oncology, in the Department of Medicine, Massachusetts General Hospital, discusses the eligibility criteria for PARP inhibitors in advanced ovarian cancer.

Historically, platinum-sensitivity has been used to predict for response to PARP inhibition, says Penson. Now, the histology, genetic markers, and the treatment-free interval are all taken into consideration. Notably, patients with clear cell or mucinous tumors are more likely to benefit from bevacizumab (Avastin) than they are from a PARP inhibitor.

Additionally, CA-125 levels can help determine the magnitude of benefit patients will experience from a PARP inhibitor, says Penson. In patients who get a rapid response to platinum-based therapy in the recurrent setting, Penson recommends giving 4 cycles of platinum-based therapy and switching to a PARP inhibitor early on to reduce toxicity and jumpstart treatment that's going to have a larger impact in terms of the duration of disease control.
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Richard T. Penson, MD, MRCP, associate professor of medicine, Harvard Medical School, and clinical director of Medical Gynecologic Oncology, in the Department of Medicine, Massachusetts General Hospital, discusses the eligibility criteria for PARP inhibitors in advanced ovarian cancer.

Historically, platinum-sensitivity has been used to predict for response to PARP inhibition, says Penson. Now, the histology, genetic markers, and the treatment-free interval are all taken into consideration. Notably, patients with clear cell or mucinous tumors are more likely to benefit from bevacizumab (Avastin) than they are from a PARP inhibitor.

Additionally, CA-125 levels can help determine the magnitude of benefit patients will experience from a PARP inhibitor, says Penson. In patients who get a rapid response to platinum-based therapy in the recurrent setting, Penson recommends giving 4 cycles of platinum-based therapy and switching to a PARP inhibitor early on to reduce toxicity and jumpstart treatment that's going to have a larger impact in terms of the duration of disease control.

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