Expanding use of rucaparib as maintenance therapy in recurrent ovarian cancer: updates from the ARIEL3 trial

Abstract

Among the novel innovative drugs being studied and investigated in recurrent ovarian cancer, poly(ADP-ribose) polymerase (PARP) inhibitors have an emerging role. There is a particular interest in these drugs as maintenance therapy and as an alternative to bevacizumab in platinum-sensitive recurrent ovarian cancer. 1 Tomao F Bardhi E Di Pinto A et al. PARP inhibitors as maintenance treatment in platinum sensitive recurrent ovarian cancer: An updated meta-analysis of randomized clinical trials according to BRCA mutational status. Cancer Treat Rev. 2019; 80101909 Summary Full Text Full Text PDF PubMed Scopus (44) Google Scholar , 2 Musella A Bardhi E Marchetti C Rucaparib: an emerging parp inhibitor for treatment of recurrent ovarian cancer. Cancer Treat Rev. 2018; 66: 7-14 Summary Full Text Full Text PDF PubMed Scopus (46) Google Scholar PARP inhibitors, including olaparib, niraparib, and rucaparib, have recently been approved in platinum-sensitive recurrent disease after a platinum-based chemotherapy with different approval policies worldwide, particularly dependent on BRCA1 or BRCA2 mutations. 3 Mirza MR Monk BJ Herrstedt J et al. Niraparib maintenance therapy in platinum-sensitive, recurrent ovarian cancer. N Engl J Med. 2016; 375: 2154-2164 Crossref PubMed Scopus (1349) Google Scholar , 4 Pujade-Lauraine E Ledermann JA Selle F et al. Olaparib tablets as maintenance therapy in patients with platinum-sensitive, relapsed ovarian cancer and a BRCA1/2 mutation (SOLO2/ENGOT-Ov21): a double-blind, randomised, placebo-controlled, phase 3 trial. Lancet Oncol. 2017; 18: 1274-1284 Summary Full Text Full Text PDF PubMed Scopus (983) Google Scholar , 5 Coleman RL Oza AM Lorusso D et al. Rucaparib maintenance treatment for recurrent ovarian carcinoma after response to platinum therapy (ARIEL3): a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet. 2017; 390: 1949-1961 Summary Full Text Full Text PDF PubMed Scopus (857) Google Scholar According to ESMO–ESGO guidelines, their use in this setting of the ovarian cancer treatment is strongly recommended (evidence level 1a). 6 Colombo N Sessa C Bois AD et al. ESMO–ESGO consensus conference recommendations on ovarian cancer: pathology and molecular biology, early and advanced stages, borderline tumours and recurrent disease. Ann Oncol. 2019; 30: 672-705 Summary Full Text Full Text PDF PubMed Scopus (370) Google Scholar Rucaparib for patients with platinum-sensitive, recurrent ovarian carcinoma (ARIEL3): post-progression outcomes and updated safety results from a randomised, placebo-controlled, phase 3 trialIn these exploratory analyses over a median follow-up of more than 2 years, rucaparib maintenance treatment led to a clinically meaningful delay in starting subsequent therapy and provided lasting clinical benefits versus placebo in all three analysis cohorts. Updated safety data were consistent with previous reports. Full-Text PDF