Maintenance Treatment of Newly Diagnosed Advanced Ovarian Cancer: Time for a Paradigm Shift?

Recent data have demonstrated substantial efficacy with poly (ADP-ribose) polymerase (PARP) inhibitors as treatment and/or maintenance therapy in patients with newly diagnosed advanced epithelial ovarian cancer (EOC). Here, we review efficacy and safety results from four recent Phase III trials in n...

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Autores principales:	Paul DiSilvestro, Nicoletta Colombo, Philipp Harter, Antonio González-Martín, Isabelle Ray-Coquard, Robert L. Coleman
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	PARP inhibitor ovarian cancer BRCA mutation homologous recombination deficiency Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/7db2bf1fae0248e4b42864c456b631ad
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spelling	oai:doaj.org-article:7db2bf1fae0248e4b42864c456b631ad2021-11-25T17:03:39ZMaintenance Treatment of Newly Diagnosed Advanced Ovarian Cancer: Time for a Paradigm Shift?10.3390/cancers132257562072-6694https://doaj.org/article/7db2bf1fae0248e4b42864c456b631ad2021-11-01T00:00:00Zhttps://www.mdpi.com/2072-6694/13/22/5756https://doaj.org/toc/2072-6694Recent data have demonstrated substantial efficacy with poly (ADP-ribose) polymerase (PARP) inhibitors as treatment and/or maintenance therapy in patients with newly diagnosed advanced epithelial ovarian cancer (EOC). Here, we review efficacy and safety results from four recent Phase III trials in newly diagnosed EOC: SOLO1 (olaparib), PAOLA-1 (olaparib in combination with bevacizumab), PRIMA (niraparib), and VELIA (veliparib). The implications of these data for current clinical practice and areas for future research are discussed, including ongoing studies of targeted agents in the newly diagnosed setting. Data from SOLO1, PAOLA-1, PRIMA, and VELIA confirm the benefit of PARP inhibitors (olaparib, niraparib, veliparib) for women with newly diagnosed EOC. The greatest benefit was seen in patients with a <i>BRCA1</i> and/or <i>BRCA2</i> mutation or in the homologous recombination deficiency (HRD)-test positive subgroup. These four well-conducted studies have generated practice-changing data. However, deciding how to apply these results in clinical practice is challenging, and substantial differences in trial design impede cross-trial comparisons. Recent PARP inhibitor approvals (olaparib, niraparib) in the newly diagnosed EOC setting have provided new maintenance treatment options for a broader patient population. The results of these studies call for personalized medicine based on biomarker profile and other factors, including tolerability, cost considerations, and physician and patient preference. Important areas for future research include appropriate use of both BRCA mutation and HRD testing to inform magnitude of PARP inhibitor benefit as well as exploring further options for patients who are HRD-test negative and for those who become PARP inhibitor resistant.Paul DiSilvestroNicoletta ColomboPhilipp HarterAntonio González-MartínIsabelle Ray-CoquardRobert L. ColemanMDPI AGarticlePARP inhibitorovarian cancerBRCA mutationhomologous recombination deficiencyNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENCancers, Vol 13, Iss 5756, p 5756 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	PARP inhibitor ovarian cancer BRCA mutation homologous recombination deficiency Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	PARP inhibitor ovarian cancer BRCA mutation homologous recombination deficiency Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Paul DiSilvestro Nicoletta Colombo Philipp Harter Antonio González-Martín Isabelle Ray-Coquard Robert L. Coleman Maintenance Treatment of Newly Diagnosed Advanced Ovarian Cancer: Time for a Paradigm Shift?
description	Recent data have demonstrated substantial efficacy with poly (ADP-ribose) polymerase (PARP) inhibitors as treatment and/or maintenance therapy in patients with newly diagnosed advanced epithelial ovarian cancer (EOC). Here, we review efficacy and safety results from four recent Phase III trials in newly diagnosed EOC: SOLO1 (olaparib), PAOLA-1 (olaparib in combination with bevacizumab), PRIMA (niraparib), and VELIA (veliparib). The implications of these data for current clinical practice and areas for future research are discussed, including ongoing studies of targeted agents in the newly diagnosed setting. Data from SOLO1, PAOLA-1, PRIMA, and VELIA confirm the benefit of PARP inhibitors (olaparib, niraparib, veliparib) for women with newly diagnosed EOC. The greatest benefit was seen in patients with a <i>BRCA1</i> and/or <i>BRCA2</i> mutation or in the homologous recombination deficiency (HRD)-test positive subgroup. These four well-conducted studies have generated practice-changing data. However, deciding how to apply these results in clinical practice is challenging, and substantial differences in trial design impede cross-trial comparisons. Recent PARP inhibitor approvals (olaparib, niraparib) in the newly diagnosed EOC setting have provided new maintenance treatment options for a broader patient population. The results of these studies call for personalized medicine based on biomarker profile and other factors, including tolerability, cost considerations, and physician and patient preference. Important areas for future research include appropriate use of both BRCA mutation and HRD testing to inform magnitude of PARP inhibitor benefit as well as exploring further options for patients who are HRD-test negative and for those who become PARP inhibitor resistant.
format	article
author	Paul DiSilvestro Nicoletta Colombo Philipp Harter Antonio González-Martín Isabelle Ray-Coquard Robert L. Coleman
author_facet	Paul DiSilvestro Nicoletta Colombo Philipp Harter Antonio González-Martín Isabelle Ray-Coquard Robert L. Coleman
author_sort	Paul DiSilvestro
title	Maintenance Treatment of Newly Diagnosed Advanced Ovarian Cancer: Time for a Paradigm Shift?
title_short	Maintenance Treatment of Newly Diagnosed Advanced Ovarian Cancer: Time for a Paradigm Shift?
title_full	Maintenance Treatment of Newly Diagnosed Advanced Ovarian Cancer: Time for a Paradigm Shift?
title_fullStr	Maintenance Treatment of Newly Diagnosed Advanced Ovarian Cancer: Time for a Paradigm Shift?
title_full_unstemmed	Maintenance Treatment of Newly Diagnosed Advanced Ovarian Cancer: Time for a Paradigm Shift?
title_sort	maintenance treatment of newly diagnosed advanced ovarian cancer: time for a paradigm shift?
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/7db2bf1fae0248e4b42864c456b631ad
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Maintenance Treatment of Newly Diagnosed Advanced Ovarian Cancer: Time for a Paradigm Shift?

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