How should PARP inhibitors be incorporated into clinical practice in later line/maintenance of platinum-sensitive ovarian cancer for PARP inhibitor-naïve patients?
Personally, if I have a PARPi naïve recurrent platinum-sensitive patient, I would have no hesitation in treating them as we did in these trials. The OS data and FDA action on the prior indications, in my opinion, was a reckless statistical exercise and potentially harmful to patients.
I would try to use them earlier rather than later- if not used frontline, I would use after the first platinum sensitive recurrence. If I have a patient with a 4th line platinum sensitive recurrence who has not yet had a parp and has the bone marrow reserve to tolerate it, I would certainly consider...
Updated overall survival data from the NOVA study demonstrated reduced median OS in the non-BRCA cohort of 31.1 months for patients treated with niraparib vs 36.5 months with placebo (HR 1.10, 95% CI 0.83-1.46). This led to a voluntary withdrawal of the FDA approval of niraparib as maintenance for p...