Risk Management & Treatment

PARP inhibitors 

PARP inhibitors are a type of that work by blocking a protein used to repair damaged . They were initially developed to treat cancers in people with an inherited  or  mutation. Since then, research and additional approvals have expanded use of PARP inhibitors to more people and situations. There are four PARP inhibitors that have received approval for treating different types of advanced cancers. 

Indications vary by:

  • type and of cancer: currently PARP inhibitors have been approved to treat breast, ovarian, pancreatic and cancers. 
  • presence of a mutation or : have been approved in different settings for:  
    • people with certain inherited mutations.
    • people with certain acquired mutations.
    • people with certain tumor biomarkers.
    • women with certain types of ovarian cancer, regardless of inherited mutation or status.
  • number of and response to prior treatments:  have been approved in different settings for:
    • platinum-sensitive or partially ovarian cancer. 
    • , (mCRPC).
    • after chemotherapy. 
    • to treat progression or recurrence after a specific number of prior treatments. 

Clinical trials studying PARP inhibitors in new settings or combinations are enrolling patients. As research continues, these approvals may expand to include treatment for additional cancers, earlier stages of cancer, people with other inherited mutations, and based on different tumor biomarkers.

 

 Indications for PARP inhibitors

Cancer type       Indication  or
inherited 
mutation
   
Lynparza
olaparib
 
rucaparib 
  
talazoparib 
 
niraparib 
breast cancer For treatment of patients who have previously received chemotherapy, or hormone therapy for patients with hormone receptor ()-positive disease  Inherited or mutation and X      
breast cancer For treatment of breast cancer Inherited or mutation and     X  
Early breast cancer at high risk for recurrence after chemotherapy in people with an inherited or mutation. Although the  has not yet approved this indication, several expert guidelines (including NCCN) now recommend this treatment option.  Inherited or mutation and X      
2-4 ovarian, or primary peritoneal  cancer First-line, for women who had a complete or partial response to platinum chemotherapy  
() testing
X
(combined with
Avastin)
     
2-4 ovarian, , or primary peritoneal  cancer First-line for women who had a complete or partial response to platinum chemotherapy Inherited or acquired (tumor) mutation in or X      
2-4 ovarian, , or primary peritoneal  cancer First-line maintenance women who had a complete or partial response to platinum chemotherapy No inherited or acquired mutation or other tumor needed        X
Recurrent ovarian,  or primary peritoneal cancer Second-line (or later) for platinum-sensitive or partially sensitive cancer  No inherited or acquired mutation or other tumor needed  X X   X
Recurrent ovarian, or primary peritoneal cancer Third-line (or later) treatment
for advanced ovarian cancer 
Inherited or acquired (tumor) mutation in or   X    
Recurrent ovarian, or primary peritoneal cancer Fourth-line (or later) treatment for advanced ovarian cancer  Inherited mutation in or X      
Recurrent ovarian, or primary peritoneal cancer Fourth-line (or later) treatment for advanced ovarian cancer  mutation or
HRD-positive
      X
pancreatic cancer  First-line for patients whose disease has not progressed on at least 16 weeks of 
platinum-based chemotherapy
Inherited mutation in or X      
castration-resistant cancer (mCRPC) Men with mCRPC whose cancer has progressed following treatment with Xtandi (enzalutamide) or  Zytiga (abiraterone) Inherited mutation in or or
tumor mutation one of
the following genes: 
ATM, , , , , CDK12, , FANCL, , RAD51B, ,  RAD54
X      
castration-resistant cancer (mCRPC) Men with mCRPC who have been treated with androgen receptor-directed therapy and a taxane-based chemotherapy Inherited or acquired (tumor) mutation in or   X    
Last updated January 31, 2022