David O’Malley, MD, discusses remaining questions in the ovarian cancer field.
David O’Malley, MD, professor, Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, and director, Division of Gynecologic Oncology at The Ohio State University Comprehensive Cancer Center—The James, discusses remaining questions in the ovarian cancer field.
One of the biggest questions still in ovarian cancer is regarding how to figure out what group of patients will benefit the most from each therapy, explains O’Malley. Patients with BRCA mutations will benefit from PARP inhibitors, according to O’Malley. The PRIMA and VELIA trials, which were published in 2019, looked at PARP inhibitors in frontline ovarian cancer.
Beyond BRCA1/2-mutated patients, the homologous recombination deficiency positivity must be defined as well as which test to use, says O’Malley. Additionally, for patients who are biomarker negative, how much benefit are they getting from PARP inhibitors? A subanalysis of the PAOLA-1 trial demonstrated that combination therapy with PARP inhibitors did not demonstrate a benefit in biomarker-negative patients. Questions still remain regarding the optimal patient to receive PARP inhibition as first-line maintenance, concludes O’Malley.