New Drugs, PARP Inhibitors, Have Potential to Benefit Larger Patient Populations in Ovarian Cancer

The addition of 3 PARP inhibitors to the landscape of ovarian cancer—rucaparib (Rubraca), olaparib (Lynparza), and niraparib (Zejula)—have led to practice-changing, targeted treatment options for patients whose diseases progress on chemotherapy. The recent FDA approvals of olaparib and niraparib in the maintenance settings, specifically, have opened a new door where previously there were no such therapies available.

Now, clinical trials are testing PARP inhibitors in combination with immunotherapy to increase antitumor activity. Rucaparib is currently being explored in combination with atezolizumab (Tecentriq) in a phase Ib open-label study, with dose-finding and dose-expansion phases (NCT03101280). For the dose-expansion phase, patients must have a deleterious germline or somatic BRCA 1/2 mutation or tumors that are BRCA wild-type, but show high levels of loss of heterozygosity.

The ongoing confirmatory study for rucaparib’s approval, ARIEL4, is comparing rucaparib with chemotherapy in patients with BRCA-positive ovarian, fallopian tube, or primary peritoneal cancer, who have received at least 2 prior platinum-based chemotherapy regimens (NCT02855944).

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