Dr. Konecny on the Value of PARP Inhibitors in Ovarian Cancer
Gottfried E. Konecny, MD
Gottfried E. Konecny, MD, associate professor of medicine, University of California, Los Angeles, discusses studies that demonstrate the value of PARP inhibitors in the treatment of patients with ovarian cancer.
The ARIEL3 study assessed the value of adding rucaparib (Rubraca) to treatment of patients with recurrent, platinum-sensitive disease. Many patients required dose reductions during this trial. Despite dose reductions, the data are statistically significant and clinically meaningful, states Konecny.
The NOVA study compared niraparib (Zejula) to placebo in a 2:1 fashion in patients who had a partial or complete response to a platinum-based agent and normalization of CA-125. Over 60% of patients had to dose reduce, but retrospective studies showed the dose reduction did not minimize the treatment effect, explains Konecny.
Study 19 assessed the use of olaparib (Lynparza) as maintenance therapy in ovarian cancer. Patients who had a good response to prior chemotherapy received the capsule form of 400 mg twice daily. This study is compounded by the SOLO2 study, which looked at the improvement in progression-free survival (PFS) with olaparib, explains Konecny. Patients who had shown a partial or complete response after platinum-based chemotherapy received 300 mg twice daily in tablet form. All studies showed approximately 4- to 5-fold improvements in PFS in patients who had a germline or somatic mutation. Additionally, there was a more than doubling in PFS in patients who had a BRCA-like signature and approximately a 3- to 4-month improvement in patients who were exquisitely platinum-sensitive and biomarker-negative, states Konecny.