Dr. Zakhour on Clinical Trials Examining Frontline Maintenance PARP Inhibitors in Ovarian Cancer

Mae Zakhour, MD, a gynecologic oncologist and associate fellowship program director for the Gynecologic Oncology Fellowship at the University of California, Los Angeles Health, discusses clinical trials that evaluated frontline maintenance PARP inhibitors in patients with ovarian cancer.

The phase 3 SOLO-1 trial was the first to examine the use of the PARP inhibitor olaparib (Lynparza) as a maintenance treatment in approximately 400 patients, according to Zakhour. Patients enrolled to the study were required to have either a confirmed or suspected BRCA mutation. The risk of progression or death was 70% lower in participants who received olaparib compared with those who received placebo, says Zakhour. A clear delineation could be seen with regard to progression-free survival (PFS) curves, although no statistically significant improvement in overall survival was observed at 3 years.

Additionally, the phase 3 PAOLA-1 trial examined the use of bevacizumab (Avastin) plus olaparib as frontline maintenance treatment in about 800 patients with advanced ovarian cancer, Zakhour adds. Patients were randomized 2:1 to receive either olaparib plus bevacizumab or placebo; notably, they were stratified based on homologous recombination deficiency (HRD) status. Data indicated a statistically significant difference in PFS in the intent-to-treat cohort with the doublet, particularly among those with HRD positivity, Zakhour concludes.