Table 1

Ongoing clinical trials investigating the use of PARPi for systemic therapy de-escalation strategies in ovarian cancer

Trial (NCT identifier)	Design	PARPi	Adjuvant therapy	Biomarker status	Primary endpoints	Estimated enrollment	Status
Upfront: neoadjuvant
NOW (NCT03943173)	Monocenter, single-arm, phase I	Olaparib 300 mg orally twice daily for two 28-day cycles	Either surgery → CHT for up to four cycles or NACT for up to four cycles → surgery, followed by olaparib, at the physician’s discretion	BRCA-mutated	Feasibility	17	Recruiting
OLAPem (NCT04417192)	Multicenter, single-arm, phase II	Olaparib 300 mg orally twice daily for two 21-day cycles ± pembrolizumab	NR	HRD	ORR	30	Active, not recruiting
NUVOLA (NCT04261465)	Multicenter, single-arm, phase II	Olaparib 300 mg orally twice daily for three consecutive days (D1-D3), every week for each cycle plus weekly carboplatin and paclitaxel for three cycles	Carboplatin and paclitaxel	BRCA-mutated	Pathological complete response	35	Unknown
IMPACT (NCT03378297)	Monocenter, single-arm, phase I, randomized window-of-opportunity study	Olaparib for 10–14 days	NR	NR	Changes in the expression of biomarkers	Olaparib: 32 Control: 16	Completed
NANT (NCT04507841)	Multicenter, single-arm, phase II	Niraparib 100–300 mg once daily	NR	HRD	ORR, R0 resection rate	53	Recruiting
OPAL-C (NCT03574779)	Multicenter, phase II, multicohort umbrella, randomized	Niraparib 100–300 mg once daily for three 21-day cycles vs standard of care plus one run-in cycle of carboplatin-paclitaxel during pre-screening	Up to three 21-day cycles of platinum-taxane doublet ± bevacizumab followed by niraparib ± bevacizumab	HRD	ORR	125	Recruiting
Upfront: adjuvant
N-PLUS (NCT05460000)	Multicenter, phase III, randomized (1:1)	Niraparib 100–300 mg once daily following PDS with R0	Six cycles vs three cycles of carboplatin and paclitaxel	HRD	RFS	640	Recruiting
Recurrence (platinum-eligible)
NEO (NCT02489006)	Multicenter, phase II, randomized	Olaparib 300 mg orally twice daily for six weeks (± two weeks) prior to surgery	Olaparib, 300 mg orally twice daily ± standard chemotherapy	All-comers	Difference in levels of PAR or PARP-1 before and after olaparib. Mutations in HR genes in germline tissue compared with tumor tissue.	71	Active, not recruiting

BRCA, BReast CAncer genes; CHT, chemotherapy; HR, homologous recombination; HRD, homologous recombination deficiency; NACT, neoadjuvant chemotherapy; NCT, National Clinical Trial identifier number; NR, not reported; ORR, overall response rate; PAR, poly(ADP-ribose); PARPi, poly(ADP-ribose) polymerase inhibitors; PDS, primary debulking surgery; R0, no gross residual tumor after surgery; RFS, recurrence-free survival.