Dr Slomovitz on the Current Role of PARP Inhibitors in Ovarian Cancer

Brian M. Slomovitz, MD, director, Gynecologic Oncology, co-chair, the Cancer Research Committee, Mount Sinai Medical Center, professor, Obstetrics and Gynecology, Florida International University, discusses the optimizing the role for PARP inhibition in patients with ovarian cancer, highlighting the agents’ efficacy in patients whose disease harbors BRCA mutations.

The use of PARP inhibitors in the treatment of patients with ovarian cancer has impacted the treatment landscape, particularly when utilized in the first-line setting, Slomovitz begins. The phase 3 SOLO-1 trial (NCT01844986) enabled this paradigm shift by demonstrating that patients with BRCAmutations who received the PARP inhibitor olaparib (Lynparza) experienced a significant improvement in overall survival (OS) vs placebo, Slomovitz reports. The median OS was 75.2 months in patients treated with placebo, though the median OS was not reached in patients treated with olaparib. The 60-month OS rate in the experimental group was 73.1% vs 63.4% in the control group. At 84 months, the respective rates were 67.0% for the experimental arm and 46.5% for the control arm.

Evidence from SOLO-1 indicates that PARP inhibitors provide long-term disease control and may have potential to be curative in this setting, Slomovitz says, emphasizing that this outcome is rare for patients with advanced ovarian cancer. This signifies a substantial departure from the historical trajectory of the disease, he adds.

For patients who did not receive PARP inhibitors in the first-line setting, there is still a clear indication for their use as maintenance therapy in the second line, Slomovitz continues. This includes patients displaying either somatic or hereditary BRCA mutations, he notes. By extending the benefits of PARP inhibitors into the second-line setting, the medical community is further optimizing the management of ovarian cancer, particularly for individuals with specific genetic profiles, Slomovitz states. The expanding roles of PARP inhibitors in advanced ovarian cancer are a testament to the growing understanding of the disease's underlying biology and the evolution of precision medicine, he concludes.