What is the role of poly ADP ribose polymerase (PARP) inhibitors in the treatment of ovarian cancer?

Updated: Jan 14, 2019
  • Author: Shannon M Grabosch, MD; Chief Editor: from Memorial Sloan-Kettering - Yukio Sonoda, MD  more...
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Answer

Answer

PARP inhibitors are FDA approved as maintenance or treatment in a platinum-sensitive relapse in patients who have had at least a partial platinum response.

Olaparib (Lynparza) is available as either tablets or capsules with distinct indications. Do not substitute olaparib tablets with olaparib capsules on a mg-to-mg basis due to differences in the dosing and bioavailability of each formulation.

Olaparib treatment indication

Deleterious or suspected deleterious germline BRCA-mutated (gBRCAm) advanced ovarian cancer in patients who have been treated with three or more prior lines of chemotherapy

Capsules: 400 mg PO BID [46]

Tablets: 300 mg (tablet) PO BID [47, 48]

Olaparib maintenance indications

Recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer, in patients who have in complete or partial response to platinum-based chemotherapy

First-line maintenance treatment of deleterious or suspected deleterious germline or somatic BRCA-mutated (gBRCAm or sBRCAm) advanced epithelial ovarian, fallopian tube, or primary peritoneal cancer in patients who are in complete or partial response to first-line platinum based chemotherapy

Tablets only: 300 mg PO BID

Rucaparib (Rubraca) 600 mg PO BID continuously is indicated for monotherapy of women with deleterious BRCA mutations (germline and/or somatic) associated with advanced ovarian cancer who have been treated with two or more prior lines of chemotherapy. [49] This agent is also indicated for maintenance treatment of recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer in patients who are in a complete or partial response to platinum-based chemotherapy. [50, 49]

Niraparib (Zejula) 300 mg PO daily is approved for maintenance treatment for recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer in women who have had complete or partial response to platinum-based chemotherapy independent of BRCA status. [51]


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