Dr. Monk on Guidelines for Maintenance PARP Inhibitors in Ovarian Cancer

Bradley J. Monk, MD, FACS, FACOG, professor, Division of Gynecologic Oncology, Arizona Oncology (US Oncology Network), University of Arizona College of Medicine, Creighton University School of Medicine at St. Joseph’s Hospital; medical director, Gynecologic Program, US Oncology Research Network; and co-director, GOG Partners, highlights current guidelines for utilizing maintenance PARP inhibitors in the treatment of patients with ovarian cancer.

In October 2020, ASCO guidelines for PARP inhibition were published in the Journal of Clinical Oncology, Monk says. These guidelines were transformational, as they dictate that patients with newly diagnosed, stage III/IV epithelial ovarian, tubal, or primary peritoneal cancer should be considered for treatment with niraparib (Zejula), while patients with a BRCA tumor mutation should be considered for treatment with olaparib (Lynparza), according to Monk. The other indications in the setting of platinum-sensitive maintenance therapy are listed as “may,” in terms of treatment with these agents, which is a lower level of recommendation compared with “should,” Monk explains.

These guidelines provide clinical guidance for how healthcare providers should utilize either niraparib in all-comers or olaparib in molecularly defined subsets in the frontline maintenance treatment setting for patients with ovarian cancer, Monk concludes.