Now that there are three FDA-approved PARP inhibitors for use in ovarian cancer (niraparib, rucaparib, olaparib), how do you decide which one to use?

One, niraparib is only approved for maintenance after treatment of platinum sensitive recurrence. Olaparib and rucaparib are approved for treating active, measurable disease. Olaparib for germline BRCA mutation carriers after 3 prior therapies, rucaparib for treating patients with germline or somatic BRCA mutations after two prior therapies. This is likely to change soon as the SOLO2 treatment using olaparib (a new formulation) as maintenance after treatment of platinum sensitive relapse in BRCA mutation carriers was recently reported and likely will have FDA review soon. Numerous other PARP inhibitor studies are in process or completed.

At this time I treat based on the above approvals. We have a lot of trials examining PARP inhibitors for...

In Brazil public health PARP inhibitors for use in ovarian cancer (niraparib, rucaparib, olaparib) is not available is public hospitals.

The olaparib and rucaparibe were used only in clinical trials.

Olaparib was used in SOLO 1, SOLO 2 and SOLO 3 trials and Rucaparibe was used in Ariel 4 trial.

SOLO 1, SOLO 2 for maintenance.

SOLO 3 for monotherapy tretament

Rucaparibe for monotherapy tretament