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Ovarian Cancer

ASCO guidelines cite significant improvement in progression-free survival when PARP inhibitors are used as maintenance therapy or in the setting of recurrent disease in women with advanced ovarian cancer who have responded to platinum-based chemotherapy in the first line.
In an analysis of the phase 3 PRIMA study, niraparib monotherapy as first-line maintenance after platinum-based chemotherapy improved progression-free survival in women with newly diagnosed advanced ovarian cancer regardless of BRCA mutation status or homologous recombination status (deficient or proficient).
In the PAOLA-1 study, women with advanced ovarian cancer, regardless of BRCA mutation status, experienced a 40% reduction in the risk for disease progression or death when randomized to olaparib plus bevacizumab compared with placebo and bevacizumab. The reduction in risk with olaparib was greatest in patients whose tumors were homologous recombination deficient.
In a 4-arm randomized study, providing telephone genetic counseling only to those women who have a pathogenic mutation or who request the counseling is noninferior to mandatory pre- and posttest counseling, which may represent a new paradigm for genetic testing.
In the phase 2 OVARIO study, median progression-free survival has not yet been reached in women with advanced ovarian cancer who are being treated with the combination of niraparib and bevacizumab after response to first-line platinum-based chemotherapy plus bevacizumab. The combination did not appear to cause cumulative toxicities.
An all-oral regimen in women with recurrent platinum-sensitive ovarian cancer did not show superiority to platinum-based regimens on the outcome of progression-free survival.
In a meta-analysis of 7 large randomized clinical trials, PARP inhibitors were not significantly more likely to cause secondary hematologic malignancies compared with control groups.
A pooled analysis of 2 studies using rucaparib for the treatment of patients with recurrent high-grade ovarian cancer supported the approved starting dose of 600 mg twice daily.
A global phase 3 randomized study is currently enrolling patients with stage III or IV high-grade nonmucinous epithelial ovarian cancer to assess the efficacy of an investigational anti–PD-1 humanized monoclonal antibody plus standard of care as first-line treatment and maintenance. The primary outcome measure is progression-free survival.
In a phase 2 study of women with recurrent platinum-sensitive ovarian cancer, safety and efficacy end points favored the combination of niraparib and bevacizumab over niraparib monotherapy.
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