Introduction/Background Ovarian cancer is the fifth leading cause of death of women in the United Kingdom, with most of these deaths being attributed to high-grade serous ovarian carcinomas (HGS-OvCa). Ovarian cancer responds well to treatment with chemotherapy often achieving complete clinical, radiological and marker response. However, unfortunately many women relapse and require further treatment. Treatment that reduces the risk of relapse would provide a major step in the treatment of ovarian cancer.
Methodology A systematic search was conducted of three databases; PubMed, Scopus and MEDLINE. The terms ‘ovarian cancer’, ‘PARP inhibitors’ and ‘platinum’ were added to the databases in order to narrow down the search results. Inclusion criteria were phase 2 and phase 3 trials, both BRCA and non-BRCA mutations, good response to platinum therapy, paper in the English language and published within the last 10 years. Primary endpoints include the progression free survival and tolerability towards treatment.
Results Benefit is seen in all groups of patients although the greatest benefit is seen in patients with BRCA mutations. For trials of niraparib, olaparib and rucaparib, the median months of progression-free survival increased by an average of 15.5 months, 13.6 months, and 11.2 months respectively. The treatment is well tolerated with the studies showing no compromise of quality of life compared to patients in the control arms who received placebo. Dose adjustment was required in a small proportion of patients and less than 15% of patients discontinued treatment due to adverse effects,.
Conclusion This systematic review supports the use of PARP inhibitors in the maintenance of response following treatment with platinum-based chemotherapy in patients with relapsed ovarian cancer. However, longer follow up is required to assess whether these encouraging results and the improvement in progression free survival will translate into improvement in overall survival.
Disclosures None to disclose.
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