Dr. Monk on the Utility of PARP Inhibitors as Maintenance Therapy in Ovarian Cancer

Bradley J. Monk, MD, FACS, FACOG, professor, Division of Gynecologic Oncology, Arizona Oncology (US Oncology Network), University of Arizona College of Medicine, Creighton University School of Medicine at St. Joseph’s Hospital, medical director, Gynecologic Program, US Oncology Research Network, and co-director, GOG Partners, discusses the utility of PARP inhibitors as maintenance therapy in ovarian cancer.

Of the 9 FDA approvals for PARP inhibitors for use in ovarian cancer, 3 are indicated for use as maintenance therapy in the recurrent setting for patients with platinum-sensitive disease, Monk explains. These patients have to have a response to platinum-based therapy to qualify for maintenance PARP inhibition per the inclusion criteria from the phase 2 Study 19 (NCT00753545) trial, and the phase 3 SOLO-2 (NCT01874353), NOVA (NCT01847274), and ARIEL3 (NCT01968213) trials. Moreover, patients with platinum-sensitive disease are likely to respond to maintenance PARP inhibition irrespective of homologous recombination deficiency or BRCA status, Monk says.

Treatment decisions are needed to select between olaparib (Lynparza), niraparib (Zejula), and rucaparib (Rubraca) because the FDA indications are identical, Monk explains. The decision requires a shared and personalized approach between the patient and provider, Monk concludes.