Dr. Cosgrove on the Utilization of PARP Inhibition in Ovarian Cancer

Casey M. Cosgrove, MD, gynecologic oncologist, The Ohio State University Comprehensive Cancer Center—The James, and assistant professor, Department of Gynecologic Oncology, The Ohio State University College of Medicine, discusses the utilization of PARP inhibition in ovarian cancer.

PARP inhibition in platinum-sensitive ovarian cancer is used in 2 main settings: maintenance and treatment. When using PARP inhibitors as maintenance therapy, patients recur, receive platinum-based chemotherapy again, achieve a complete or partial response, and then go on to receive a PARP inhibitor as a maintenance therapy. Olaparib (Lynparza), rucaparib (Rubraca), and niraparib (Zejula) are all FDA approved for use as maintenance therapy in patients with ovarian cancer, says Cosgrove. Since it is difficult to compare the 3 PARP inhibitors, choosing among them is based on provider preference and safety profiles, adds Cosgrove.

PARP inhibitors are also being used in platinum-sensitive ovarian cancer as treatment. Olaparib, rucaparib, and niraparib are also approved for use in the treatment setting for this patient population, albeit for different indications, with niraparib most recently getting FDA approval in October 2019. When determining which PARP inhibitor to give a patient with ovarian cancer, providers mostly rely on the presence of some sort of biomarker, including the presence of BRCA mutations or homologous recombination deficiency, concludes Cosgrove.