Table 1

Overview of the pivotal phase III randomized controlled trials with poly (ADP-ribose) polymerase inhibitors (PARPi) in the first-line setting.

Parameter	SOLO1	PAOLA1	PRIMA	PRIME	ATHENA-MONO
Drug	Olaparib	Olaparib+bevacizumab	Niraparib	Niraparib	Rucaparib
Histotype	HGSOC and HGEOC	HGSOC and HGEOC	HGSOC and HGEOC	HGSOC and HGEOC	HGSOC and HGEOC
Eligibility	Stage III-IV BRCAm Response to platinum	Stage III-IV HRD-positive Response to platinum At least two cycles of bevacizumab with chemotherapy	Stage III with RT>0, NACT, or inoperable Stage IV Response to platinum	Stage III-IV Response to platinum	Stage III-IV undergoing surgical cytoreduction (complete resection was permitted) Response to platinum
Starting dose	300 mg twice daily	300 mg twice daily + 15 mg/kg every 3 weeks	Initially fixed dose of 300 mg, then individualized dose: 300 mg (if weight >77 kg and platelet count >150 000/µl) or 200 mg	Individualized dose: 300 mg (if weight >77 kg and platelet count >150 000/µl) or 200 mg	600 mg twice daily
Duration	Up to 2 years (in the absence of unacceptable toxicity or PD)	Olaparib: up to 2 years (in the absence of unacceptable toxicity or PD) Bevacizumab: up to 15 months/22 cycles (in the absence of toxicity or PD)	Up to 3 years (in the absence of unacceptable toxicity or PD)	Up to 3 years (in the absence of unacceptable toxicity or PD)	Up to 2 years (in the absence of unacceptable toxicity or PD)
Mutational status	BRCAm	HRD-positive	All-comers	All-comers	All-comers
HRD test	–	Myriad MyChoice	Myriad MyChoice	BGI	FoundationOne
Benefit across biomarkers
ITT	7-year OS: 67.0% vs 46.5% (HR: 0.55; 95% CI 0.40 to 0.76; p=0.004)	5-year OS: 47.3% vs 41.5% (HR: 0.92; 95% CI 0.76 to 1.12)	3.5-year PFS: 13.8 vs 8.2 months (HR: 0.66; 95% CI 0.56 to 0.79; p<0.0001)	PFS: 24.8 vs 8.3 months (HR: 0.45; 95% CI 0.34 to 0.60; p<0.001)	PFS: 20.2 vs 9.2 months (HR: 0.52; 95% CI 0.40 to 0.68; p<0.0001)
BRCAm		5-year OS: 73.2% vs 53.8% (HR: 0.60; 95% CI 0.39 to 0.93; p<0.001)	1.2-year PFS: HR 0.40; 95% CI 0.27 to 0.62	PFS: NR vs 10.8 months (HR: 0.40; 95% CI 0.23 to 0.68; p<0.001)	PFS: NR vs 14.7 months (HR: 0.40; 95% CI 0.21 to 0.75)
HRD+ (including BRCAm)	–	5-year OS 65.5% vs 48.4% (HR: 0.62; 95% CI 0.45 to 0.85; p<0.001)	3.5-year PFS: 24.5 vs 11.2 months (HR: 0.52; 95% CI 0.40 to 0.68; p<0.0001)	PFS: HR 0.48	PFS: 28.7 vs 11.3 months (HR: 0.47; 95% CI 0.31 to 0.72; p=0.0004)
HRD+/BRCAwt	–	5-year OS: 54.7% vs 44.2% (HR: 0.71; 95% CI 0.45 to 1.13; p<0.001)	1.2-year PFS: HR 0.50; 95% CI 0.31 to 0.83	PFS: 24.8 vs 11.1 months (HR: 0.58; 95% CI 0.36 to 0.93; p=0.022)	PFS: 20.3 vs 9.2 months (HR: 0.58; 95% CI 0.33 to 1.01)
HRD–	–	5-year OS: 25.7% vs 32.3% (HR: 1.19; 95% CI 0.88 to 1.63)	3.5-year PFS: HR 0.65; 95% CI 0.49 to 0.87; p<0.00038	PFS: HR 0.41; 95% CI 0.25 to 0.65; p<0.001	PFS: 12.1 vs 9.1 months (HR: 0.65; 95% CI 0.45 to 0.95)
Limitations	Lack of bevacizumab arm	Lack of PARPi alone arm	Lack of bevacizumab arm Low-risk patients (stage III with no residual disease after primary debulking surgery) were excluded	Lack of bevacizumab arm	Lack of bevacizumab arm

BRCAm, BRCA-mutated; BRCAwt, BRCA-wild type; CI, confidence interval; HGEOC, high-grade endometrioid ovarian cancer; HGSOC, high-grade serous ovarian cancer; HR, hazard ratio; HRD, homologous recombination (DNA repair) deficiency; ITT, intention-to-treat population; NACT, neoadjuvant chemotherapy; NR, not reached; OS, overall survival; PD, progressive disease; PFS, median progression-free survival; RCT, randomized clinical trial; RT, residual tumor.