PARP inhibition as frontline therapy in ovarian cancer

Clin Adv Hematol Oncol. 2020 Sep;18(9):550-556.

Abstract

Poly(ADP-ribose) polymerase (PARP) inhibitors have been rapidly integrated into clinical practice for women with ovarian cancer. Currently, PARP inhibitors are approved as frontline maintenance treatment for patients with and without BRCA-associated cancers, and they are listed by the National Comprehensive Cancer Network (NCCN) as a treatment option for all high-grade serous and endometrioid cancers with or without bevacizumab. PARP inhibitors are also approved as maintenance treatment following a response to platinum-based therapy in the recurrent setting, irrespective of biomarker status. Additionally, PARP inhibitors are approved as third-line treatment and beyond in lieu of chemotherapy for patients with BRCA-associated cancers, and as fourth-line treatment and beyond for patients with platinum-sensitive homologous recombination-deficient tumors. They are also listed by the NCCN in combination with bevacizumab for the treatment of patients who have platinum-sensitive recurrent disease. The first part of this 2-part review focuses on the changing paradigm of frontline therapy options resulting from the recent approvals of PARP inhibitors; the second part considers the role of PARP inhibition in recurrent ovarian cancer.

Publication types

  • Review

MeSH terms

  • Bevacizumab / therapeutic use*
  • Carcinoma, Ovarian Epithelial* / drug therapy
  • Carcinoma, Ovarian Epithelial* / enzymology
  • Carcinoma, Ovarian Epithelial* / pathology
  • Female
  • Humans
  • Neoplasm Proteins* / antagonists & inhibitors
  • Neoplasm Proteins* / metabolism
  • Ovarian Neoplasms* / drug therapy
  • Ovarian Neoplasms* / enzymology
  • Ovarian Neoplasms* / pathology
  • Poly(ADP-ribose) Polymerase Inhibitors / therapeutic use*
  • Poly(ADP-ribose) Polymerases / metabolism*

Substances

  • Neoplasm Proteins
  • Poly(ADP-ribose) Polymerase Inhibitors
  • Bevacizumab
  • Poly(ADP-ribose) Polymerases