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Expert Weighs in on PARP Inhibitor Advances in Ovarian Cancer

Angelica Welch
Published: Monday, Aug 07, 2017

Douglas A. Levine, MD

Douglas A. Levine, MD
The PARP inhibitor explosion in ovarian cancer continues to advance, offering additional therapeutic options for patients.

at ASCO to provide his insight on some of the recent data with PARP inhibitors in ovarian cancer, as well as his predictions for the field in the next several years.

OncLive: What is your perspective on the posthoc analysis of niraparib in ovarian cancer?

Levine: The niraparib study showed that in patients who had a partial response, in addition to those who had a complete response, the outcomes are very similar. What that means is that if you have a BRCA mutation, you have a very long progression-free interval of PFS and, if you have homologous recombination deficiency, you also have a fairly good outcome with that drug. One thing that is buried in the data is that outcomes are much less successful when you do not have a BRCA mutation or do not have a homologous recombination defect. 

Do you believe that these PARP inhibitors are game-changers for this field?

The PARP inhibitor landscape is getting more complex. It is wonderful that we have all of these great drugs and options for our patients, it is a real breakthrough. It’s an incredibly exciting time and it’s remarkable; however, it is complex and confusing. The real question is when to use the PARP inhibitors and for which types of patients. The label, the indication, and the insurance coverage will drive that to a greater or a lesser extent. One thing we have to think about is that some of the agents are indicated for patients who have a germline and/or somatic mutation, and niraparib has an indication for all comers, yet the effect is much less when you do not have a BRCA mutation or a homologous recombination defect. 
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