Dr. Konecny on Response to PARP Inhibitors in Ovarian Cancer

Gottfried E. Konecny, MD, associate professor of medicine, University of California, Los Angeles, discusses response to PARP inhibitors in ovarian cancer.

There are subsets of patients who derive great benefit from PARP inhibitors, and that should direct physicians’ treatment decisions, says Konecny. Additionally, physicians have to consider the potential toxicities of treatment or the potential cost of treatment as there are also patients who derive clinically less meaningful improvements.

PARP inhibition can be thought of as a targeted therapy in cells that have DNA repair-deficient mechanisms, says Konecny. Physicians need to have a reliable test or assay to select patients who may respond to PARP inhibition if these drugs are moved outside the realm of extreme platinum sensitivity.

Genomic scarring is a very stable feature, explains Konecny. Once a tumor develops genomic scarring, it has an increased fraction of DNA that is affected by gains or losses. Genomic scarring is something that stays throughout the further progression of disease. Therefore, it may be a combination of test assays, including sequencing, expression studies, and examining copy number changes that will give physicians a more reliable assay to specify which patients will respond to PARP inhibitors.