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Studies have shown that ovarian cancer survivors with BRCA 1 mutations generally have a better survival rate than women with sporadic ovarian cancer. There is some speculation that this may be due to a higher sensitivity of BRCA 1-associated ovarian cancers to the chemotherapy drugs called platinums which are typically used for ovarian cancer treatment.
Women with ovarian cancer and BRCA mutations are eligable for a type of targeted therapy called PARP inhibitors. PARP inhibitors are a type of drug that exploit that defect by blocking the PARP enzyme that cells use to repair damaged DNA. Theoretically, these drugs should spare healthy cells that have at least one working copy of the BRCA gene, with limited side effects or toxicity. Some women with ovarian cancer who do not have BRCA mutations also respond to PARP inhibitors, probably because their cancers also have a decreased ability to repair DNA. It is not yet known if ovarian cancer caused by inherited mutations in other genes such as BRIP1, RAD51C, or RAD51D can also be targeted by PARP inhibitors. A lot of effort is now being focused on developing biomarkers or tumor tests to identify signs of this diminished DNA repair ability in cancers, so that patients without BRCA mutations who are likely to respond to PARP inhibitors can be identified.
Lynparza (also known as olaparib) is a PARP inhibitor drug approved by the FDA to treat ovarian, fallopian tube, and primary peritoneal cancer in women who carry a BRCA mutation, and who have received three or more previous lines of chemotherapy. Lynparza has also been approved in Europe, but for a different indication: it is used there as maintenance therapy for recurrent BRCA-related ovarian cancer in women who have a good response to platinum chemotherapy.
Rubraca (also known as rucaparib) is approved by the FDA to treat women with advanced ovarian cancer who have had two or more prior treatment and who have inherited mutations in BRCA or whose tumors have BRCA mutations as detected by the FoundationFocus CDxBRCA companion diagnostic.
For more information on Lynparza, Rubraca, and other PARP inhibitors in clinical trials, please see our section on targeted therapies.