New FDA approval of PARP inhibitor for maintenance therapy in ovarian cancer

Expert Guidelines

The National Comprehensive Cancer Network (NCCN) is a national panel of experts that creates guidelines for cancer treatment. For women who have had a complete or partial response to fist-line therapy, the NCCN recommends the following:

• Women who do not have a BRCA mutation or it is unknown if they have a BRCA mutation (and did not receive bevacizumab during fist-line treatment) consider Zejula (niraparib) as maintenance therapy.
• Women who have a BRCA mutation or whose tumor has a BRCA mutation (and did not receive bevacizumab during first-line treatment) consider Zejula (niraparib) or Lynparza (olaparib) as maintenance therapy.
• Women who do not have a BRCA mutation or it is unknown if they have a BRCA mutation (who received bevacizumab and chemotherapy as fist-line treatment) consider Lynparza alone or in combination with bevacizumab as maintenance therapy.
• Women who have a BRCA mutation or whose tumor has a BRCA mutation (who received bevacizumab and chemotherapy as fist-line treatment) consider Zejula (niraparib) or Lynparza (olaparib) alone or Lynparza (olaparib) plus bevacizumab as maintenance therapy.

Questions To Ask Your Health Care Provider

• Is maintenance therapy with Zejula anoption for my ovarian cancer?
• If Zejula is not an option for me right now, might it be an option in the future?
• What side effects might I experience with this treatment?
• If I have serious side effects, will I need to stop treatment?
• Are any other agents available to treat my cancer?

Open Clinical Trials

• NCT03522246: A Study in Ovarian Cancer Patients Evaluating Rucaparib and Nivolumab as Maintenance Treatment Following Response to Front-Line Platinum-Based Chemotherapy (ATHENA). ATHENA is a study for women who are newly diagnosed with ovarian cancer. The goal of ATHENA is to look at whether giving maintenance therapy with different agents improves outcomes for women who have completed front-line treatment.

• NCT02855944. ARIEL4: A Study of Rucaparib Versus Chemotherapy BRCA Mutant Ovarian, Fallopian Tube, or Primary Peritoneal Cancer Patients. ARIEL4 is a treatment study for women with relapsed, high-grade epithelial ovarian, fallopian tube, or primary peritoneal cancer who have a BRCA1 or BRCA2 mutation. ARIEL4 is designed to evaluate rucaparib against standard of care chemotherapy in women who have had at least two prior chemotherapy regimens.

• NCT03955471. A study comparing platinum-based therapy with a TSR-042 and niraparib versus standard of care platinum-based therapy as first-line treatment of Stage III or IV ovarian cancer. This study will look at the efficacy and safety of a combination of niraparib and TSR-042 (Dostarlimab), a targeted therapy in patients with advanced ovarian cancer without a known BRCA mutation who have platinum-resistant disease and who have also been previously treated with bevacizumab (Avastin).
• NCT03718091: A Non-Randomized Phase II Research Study of M6620 (VX-970) in Selected Solid Tumors to Inhibit the ATR Enzyme. This clinical trial is studying how well a targeted therapy that blocks an enzyme called ATR works in treating patients with advanced solid tumors, including ovarian cancer. The study is open to people with a BRCA1, BRCA2, or ATM mutation. The study is open to people who have previously received treatment with a PARP inhibitor.