Dr Markman on the Role of PARP Inhibitors in Ovarian Cancer

Maurie Markman, MD, president, Medicine & Science, City of Hope Atlanta, Chicago, and Phoenix, discusses the unique role of PARP inhibitors in the treatment of patients with ovarian cancer.

The role of PARP inhibitors in ovarian cancer management is crucial and intricate, Markman begins. The complexity of PARP inhibitors and data from recent clinical trials have led the FDA to retract certain indications for these agents as later lines of therapy, underscoring the necessity of learning more about these drugs, he states. Currently, PARP inhibitors are unequivocal game changers, and established themselves as the standard of care for women with documented BRCA mutations or, in specific cases, as a first-line treatment for those with homologous recombination repair deficiency, Markman explains. However, navigating the use of these agents in later lines of therapy introduces a level of uncertainty, as there are concerns that employing these drugs may potentially have adverse effects on outcomes, though the reasons for these concerns remain unclear, he notes.

Emphasizing the major role of PARP inhibitors in ovarian cancer management, particularly in earlier stages and maintenance settings, is imperative, Markman continues. Genetic testing, a complex process that encompasses germline testing and genomics, provides crucial insights, he says. Although abnormalities present in the germline are mirrored in the tumor, complexity arises from the fact that tumor abnormalities may not be present in the germline, he emphasizes. Specific abnormalities identified through genetic testing significantly affectpotential therapeutic approaches for individual women with ovarian cancer, Markman adds.

Moreover, germline information holds critical implications for family discussions, influencing family planning decisions and helping patients and oncologists assess the potential risk of ovarian cancer in a given family, Markman continues. This underscores the importance of physicians caring for women with ovarian cancer to not only comprehend the current therapeutic landscape tied to molecular abnormalities but also appreciate the potential ramifications for family-related discussions, he says. The significance of PARP inhibitors is undeniably paramount, yet the intricacies of these treatment considerations cannot be overstated, Markman concludes.