Abstract
Ovarian cancer is one of the leading causes of death from gynecologic cancers. In this present era of cancer treatment, therapeutic options for patients with advanced or recurrent ovarian cancer are limited. The present standard of care treatment for advanced ovarian cancer is a platinum-based doublet chemotherapy (paclitaxel and carboplatin with or without bevacizumab) after a maximum attempt of surgical cytoreduction. However, there are no promising options for the management of patients with ovarian cancer refractory to the platinum-based chemotherapy. Therefore, newer, safe, and more effective treatment modalities are required for patients with advanced or recurrent ovarian cancer. Poly(adenosine diphosphate [ADP]-ribose) polymerase (PARP) inhibitors have shown an impressive safety profile and anti-tumor efficacy in patients with breast cancer 1 and 2 (BRCA1 and BRCA2) gene-mutated ovarian cancer who were previously treated with the standard of care chemotherapy. We have done a detailed review of the literature to emphasize the role of PARP inhibitors in the treatment of advanced or relapsed ovarian cancer.
Highlights
BackgroundOvarian cancer is one of the leading causes of death from gynecologic cancers
This study showed a statistically significant improvement in progression-free survival (PFS) in patients treated with olaparib (8.4 months) as compared to placebo (4.8 months)
A total of 192 patients were divided into three subgroups: BRCA mutant, BRCA wild-type with high loss of heterogeneity (LOH) defined as 14% or more genomic LOH (LOH high group), or BRCA wild-type with less than 14% genomic LOH (LOH low group)
Summary
Ovarian cancer is one of the leading causes of death from gynecologic cancers. It is the fifth most common cause of cancer-related deaths amongst women of the United States. Common Grade 3 or more adverse events observed with the drug were anemia (22%) and elevations in alanine aminotransferase or aspartate aminotransferase (12%) [35] The results of this trial showed the efficacy of rucaparib in BRCA-mutant patients and suggested that the assessment of genomic LOH can help to identify platinum-sensitive ovarian cancer patients with BRCA wild-type who can respond to rucaparib. The NOVA trial results demonstrated that median PFS for patients with platinum-sensitive, recurrent ovarian cancer was significantly longer in patients who received niraparib as compared to placebo, irrespective of the BRCA mutation or HRD status [36]
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