Real-World Efficacy and Safety of PARP Inhibitors in Recurrent Ovarian Cancer Patients With Somatic BRCA and Other

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Yifang Eva Pan1, Annette Hood1, Hiba Ahmad2

  • 1Smilow Cancer Hospital, Yale New Haven Health, New Haven, CT, USA.

The Annals of Pharmacotherapy
|January 18, 2023
PubMed
Abstract

Insights

Poly (ADP-ribose) polymerase (PARP) inhibitors show benefit in recurrent ovarian cancer patients with homologous recombination (HR) mutations. These drugs offer stable disease and could benefit patients with non-BRCA HR or somatic BRCA mutations.

Area of Science:

  • Oncology
  • Genetics
  • Pharmacology

Background:

  • Limited real-world data exists for poly (ADP-ribose) polymerase (PARP) inhibitors in recurrent ovarian cancer with non-BRCA homologous recombination (HR) or somatic BRCA mutations.
  • Investigating the efficacy and safety of PARP inhibitors in these specific patient subgroups is crucial.

Purpose of the Study:

  • To evaluate the response rate, treatment duration, time to progression (TTP), and toxicities of olaparib, niraparib, and rucaparib.
  • To assess the effectiveness of PARP inhibitors in patients with somatic BRCA mutations (BRCAm) and non-BRCA HR mutations (non-BRCA HRm) in ovarian cancer.

Main Methods:

  • Retrospective study utilizing electronic medical records from December 2014 to December 2019.
  • Patient identification based on initiation of PARP inhibitors for ovarian cancer.
  • Screening for somatic BRCA1/2 or non-BRCA HR gene mutations, followed by chart review for data collection.

Main Results:

  • Overall response rate (ORR) was 50% for BRCAm patients and 9.1% for non-BRCA HRm patients; 72.7% of non-BRCA HRm patients had stable disease.
  • Median TTP was 9.5 months; treatment duration varied from 2 to 66 months.
  • High rates of dose reductions (66.7% overall) and treatment interruptions (61.9%) due to adverse events (AEs) were observed.

Conclusions:

  • PARP inhibitors demonstrated potential in maintaining stable disease for recurrent ovarian cancer patients with HR mutations.
  • The toxicities observed were comparable to those in major clinical trials.
  • Patients with non-BRCA HR and somatic BRCA mutations may benefit from PARP inhibitor therapy.
Keywords:
homologous recombination deficiencyniraparibolaparibovarian cancerrucaparibsomatic BRCA mutations

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