Dr. Moore on Immunotherapy and PARP Combinations in BRCA-Mutated Ovarian Cancer

Kathleen N. Moore, MD, assistant professor, The Stephenson Cancer Center, The University of Oklahoma, discusses combinations of immunotherapy with PARP inhibitors for patients with BRCA-mutated ovarian cancer.

There is evidence for combining PARP inhibitors with immune agents in patients with BRCA mutations, explains Moore. In ovarian cancer, there is a lot of inherent DNA damage-response abnormalities that result in mutations that could be neoantigens. Hopefully, 50% or more of patients will respond to the use of a PARP inhibitor that will increase the neoantigen load and then bring in an immune checkpoint inhibitor, says Moore.

There are many ongoing trials investigating this. For example, the TOPACIO/KEYNOTE-162 trial investigating niriparib (Zejula) plus pembrolizumab (Keytruda) in breast and ovarian cancer in BRCA wild-type and BRCA-mutated patients. That trial has only been presented in abstract form thus far, but has shown efficacy. There are planned studies in frontline ovarian cancer looking at combinations of PARP inhibitors and immunotherapy.