Susana M. Campos, MD
Ovarian cancer is the fifth overall cause of cancer death in women, and it represents 5% of all cancers in women. Most women with ovarian cancer present with stage III or IV disease, which contributes to the high mortality rate. Although there have been numerous studies evaluating the role of different therapy schedules, cytotoxic agents, and routes of administration, the backbone of therapy remains a combination of a platinum and a taxane.
Despite these encouraging results, the addition of bevacizumab in the overall population did not result in improvement in overall survival (OS). Therefore, innovative combinations in the up-front setting of patients with ovarian cancer remain a high priority.
Recently, treatment in the landscape of ovarian cancer has changed. Notably, PARP inhibitors have been approved for the treatment of recurrent ovarian cancer. In 2014, olaparib (Lynparza) was approved for patients who carried a deleterious BRCA
germline mutation and had received 3 or more prior lines of chemotherapy.3
was approved as single-agent maintenance therapy for patients with germline or somatic BRCA
Table. 1 Ongoing Studies of PARP Inhibitors in Newly Diagnosed Ovarian Cancer
Table 2. Ongoing Studies of PARP Inhibitors Combined With Checkpoint Inhibitors in Newly Diagnosed Ovarian Cancer
After a median follow-up of 41 months, the risk of disease progression or death was 70% lower with olaparib than with placebo. The HR for disease progression or death was 0.30 (95% CI, 0.23-0.41; P
In the past several years, there has been tremendous benefit from the clinical implementation of checkpoint inhibitors, which have been approved for treatment of melanoma, Hodgkin lymphoma, and bladder, kidney, and lung cancers. However, the role of checkpoint inhibitors in ovarian cancer is undefined. Several questions remain: What effect can the immune system have on ovarian cancer? What factors contribute to ovarian cancer immunogenicity? What role does PD-L1 play in ovarian cancer?
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