ESMO 2018 News - Episode 4
Kathleen Moore, MD, associate professor, Stephenson Cancer Center, University of Oklahoma, speaks to exciting PARP inhibitor abstracts in ovarian cancer presented at the 2018 ESMO Congress.
The phase III SOLO-1 trial showed a substantial benefit to olaparib (Lynparza) maintenance versus placebo in patients with newly-diagnosed advanced ovarian cancer. It is important to note that the patients who enrolled on the trial had great prognostic factors, according to Moore. These were younger women who harbored a BRCA mutation and had a great performance status. Results revealed a hazard ratio of 0.3, which translates to a 70% reduction in the risk of recurrence and a new standard of care, says Moore.
Another PARP inhibitor that has impacted the field is niraparib (Zejula), results of which were presented from the QUADRA study. The study investigated its use in heavily pretreated, homologous recombination deficiency-positive patients with platinum-sensitive ovarian cancer and demonstrated a 27% response rate. Though the emphasis has been on bringing PARP inhibitors into the frontline setting, and more specifically for those with BRCA mutations, Moore says the QUADRA study shows that the efficacy of PARP inhibitors extends beyond the frontline.
For patients with platinum-sensitive recurrent ovarian cancer, physicians have 3 potential doublets to choose from, 2 of which are carboplatin plus gemcitabine and carboplatin and pegylated liposomal doxorubicin (PLD). In the phase III ENGOT/GCIG-Intergroup study, the addition of bevacizumab (Avastin) to carboplatin and PLD was shown to be better than its addition to carboplatin and gemcitabine. The study will have an immediate impact on practice, says Moore.
Although many questions were answered at the 2018 ESMO Congress, some remain to be seen, says Moore, such as the reintroduction of a PARP inhibitor following recurrence, as well as PARP’s application outside of BRCA mutations.