The Changing Landscape in Advanced Ovarian Cancer

Transcript:Thomas Herzog, MD: It is an exciting time for the treatment of platinum-sensitive patients with ovarian cancer. We have had recent approval of bevacizumab in this space, and we have had recent approval of PARP inhibitors that also are changing the landscape very rapidly. We’ll see label changes, I believe, as we go. We recently had approval of a PARP inhibitor that would allow us to treat patients with platinum-sensitive disease. We also have a second PARP inhibitor that has been recently approved that would also fall into this space potentially. And I think it’s very interesting to look at how we make that decision between incorporating bevacizumab versus the PARP inhibitors. To me, this is a very fluid area right now. I think many clinicians are really trying to determine the best patient for the best regimen, and I’m not sure we’ve completely worked that out, frankly.

When one reviews the PARP data, they are really interesting because it’s such a fast-changing area. I think that you’ll see continual changes in the indications as more data come online, and you’ll see where the indications become more similar for the 3 PARP inhibitors.

The first PARP inhibitor to be approved over a couple of years ago now was olaparib. We then had rucaparib that was approved just recently. And then, just a couple of weeks ago, we had niraparib approved. It’s very interesting looking at this, and one of the indications has been this concept of maintenance in platinum-sensitive disease. So, treating them with chemotherapy, treating the patient with chemotherapy, looking for either a partial or a complete response, and then switching them to a PARP inhibitor at that point.

The original data with olaparib for approval were actually in patients in the fourth-line and beyond. So, it’s a little bit different looking at that, and some of those patients are actually platinum-resistant. I think one has to be careful in terms of looking at the different indications and looking at the different PARP inhibitors. You definitely have to keep up because I think you’ll see continued changes probably almost on a yearly basis with the number of trials that we’ll report over the next couple of years that will change the labeling for these compounds.

Transcript Edited for Clarity