Abstract

Homologous recombination deficiencyand VEGF expression are key pathways in high-grade ovarian cancer. Recently, three randomized practice changing trials were published: the PAOLA-1, PRIMA and VELIA trials. The use of PARPinhibitors (PARPi) following chemotherapy has become standard of care in firstline. Combination of PARPiwith anti-angiogenic agents has demonstrated synergistic activity in preclinical study. This review summarizes the body of evidence supporting the efficacy and safety of the combination of PARPiand anti-angiogenic drugs in first-line homologous recombination deficiency high-grade ovarian cancer leading to USFDA and EMA approvals. This double maintenance is supported by: a large benefit with bevacizumab + olaparib compared with olaparib alone, a rationale for additive effect, and a good safety and cost-effective profile.

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