Maintenance therapy for ovarian cancer
Maintenance therapy is a type of treatment that is given after initial standard treatment has been completed to try to keep the cancer from returning. The goal of maintenance therapy is to extend the length of time before a new recurrence emerges or even to turn a temporary remission into a long-term cure. Two types of agents—PARP inhibitors and bevacizumab—have been FDA approved for use as maintenance therapy in women with advanced ovarian, fallopian tube and primary peritoneal cancer.
PARP inhibitors for maintenance therapy
Three PARP inhibitors have received FDA approval for ovarian cancer maintenance therapy
- In 2018, Lynparza became the first PARP inhibitor to receive FDA approval for use as a maintenance therapy after first-line of chemotherapy. This approval applies to women with a BRCA1 or BRCA2 mutation and who experienced complete or partial response to their first-line platinum-based chemotherapy. This is based on the results of the SOLO1 Study which showed that patients who used Lynparza as a maintenance therapy immediately following chemotherapy had three additional years of progression-free survival (PFS) compared to a placebo.
- Lynparza and Zejula may be used as maintenance therapy for women with ovarian cancer who have received 2 or more lines of chemotherapy who had either a complete or partial response to the most recent line of recurrence therapy. Rucaparib may be used as a maintenance therapy for women with recurrent epithelial ovarian, fallopian tube or primary peritoneal cancer who are in complete or partial response to platinum-based chemotherapy. These PARP inhibitors have been approved for maintenance therapy in women with, and women without a BRCA mutation. However, research suggests that the agents work particularly well in women with a BRCA1 or BRCA2 mutation.
Bevacizumab for first-line maintenance therapy
- In 2018, the FDA approved bevacizumab (Avastin) for the treatment of patients with epithelial ovarian, fallopian tube, or primary peritoneal cancer in combination with carboplatin and paclitaxel, followed by single-agent bevacizumab, for stage III or IV disease after initial surgical resection.