Poly (ADP-ribose) Polymerase Inhibitors in the Management of Ovarian Cancer: A Drug Class Review.

Objective: To review the pharmacology, safety, efficacy, and role of poly adenosine diphosphate [ADP]-ribose polymerase (PARP) inhibitors in the treatment and maintenance of relapsed, advanced ovarian cancer.

Summary: A total of 3 phase 2 trials and 2 phase 3 trials were reviewed that evaluated the safety and efficacy of oral niraparib, olaparib, and rucaparib in patients with ovarian cancer. Progression-free survival (PFS) was evaluated in the maintenance setting for niraparib and olaparib, resulting in a PFS of 21.0 months and 8.4 months, respectively. Olaparib and rucaparib were evaluated in the treatment setting, producing a PFS of 9.4 months and 12.8 months, respectively. PFS was higher in patients with BRCA mutation when compared to patients with BRCA wild-type in both the maintenance and treatment setting across all trials evaluated. Niraparib, olaparib, and rucaparib were found to be relatively well tolerated in clinical trials, with the most common adverse events being anemia, fatigue, and nausea.

Conclusion: PARP inhibitors appear to be a safe and effective new option in the treatment and maintenance of relapsed, advanced BRCA1/2 mutant ovarian cancer. This drug class will likely have an expanding role in ovarian cancer as further trial results are published.