Newly diagnosed ovarian cancer: Which first-line treatment?

Domenica Lorusso; Valentina Ceni; Gennaro Daniele; Vanda Salutari; Antonella Pietragalla; Margherita Muratore; Camilla Nero; Francesca Ciccarone; Giovanni Scambia

doi:10.1016/j.ctrv.2020.102111

Newly diagnosed ovarian cancer: Which first-line treatment?

Cancer Treat Rev. 2020 Dec:91:102111. doi: 10.1016/j.ctrv.2020.102111. Epub 2020 Oct 9.

Authors

Domenica Lorusso¹, Valentina Ceni², Gennaro Daniele³, Vanda Salutari⁴, Antonella Pietragalla⁵, Margherita Muratore⁶, Camilla Nero⁷, Francesca Ciccarone⁸, Giovanni Scambia⁹

Affiliations

¹ Department of Women and Child Health, Division of Gynecologic Oncology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy. Electronic address: domenica.lorusso@policlinicogemelli.it.
² Department of Women and Child Health, Division of Gynecologic Oncology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy; Department of Gynecology and Obstetrics, University of Parma, Via A. Gramsci 14, 43125 Parma, Italy.
³ Department of Women and Child Health, Division of Gynecologic Oncology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy. Electronic address: gennaro.daniele@policlinicogemelli.it.
⁴ Department of Women and Child Health, Division of Gynecologic Oncology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy. Electronic address: vanda.salutari@policlinicogemelli.it.
⁵ Department of Women and Child Health, Division of Gynecologic Oncology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy. Electronic address: antonella.pietragalla@policlinicogemelli.it.
⁶ Department of Women and Child Health, Division of Gynecologic Oncology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy. Electronic address: margherita.muratore@unina.it.
⁷ Department of Women and Child Health, Division of Gynecologic Oncology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy. Electronic address: camilla.nero@policlinicogemelli.it.
⁸ Department of Women and Child Health, Division of Gynecologic Oncology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy. Electronic address: francesca.ciccarone@policlinicogemelli.it.
⁹ Department of Women and Child Health, Division of Gynecologic Oncology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy. Electronic address: giovanni.scambia@policlinicogemelli.it.

PMID: 33068886
DOI: 10.1016/j.ctrv.2020.102111

Abstract

Poly ADP -Ribose Polymerase (PARP) inhibitors (PARPi) were firstly licensed for maintenance treatment in recurrent, platinum-sensitive, platinum responsive epithelial ovarian cancer patients, harboring or not a BRCA mutation. Three new phase III trials - PAOLA1/ENGOT-OV25, PRIMA/ENGOT-OV26 and VELIA/GOG-3005 - showed that there is a role for PARPi also in first-line setting, as maintenance or in combination with platinum-based chemotherapy. Nevertheless the published trials raised several questions on what is the best treatment according to the molecular and clinical characteristics of the treated patients. This review focuses on the published data in order to inform clinician decision making on what could be the best sequence or combination of treatments for the three molecular defined cohorts of patients emerging in the first line trials (the carriers of a BRCA mutation (BRCAmut), those with a deficiency in homologous recombination system (HRd) and those with a proficient homologous recombination system (HRp)) and put the newly published data in the context of the ovarian cancer treatment landscape.

Keywords: HRD; Maintenance; Ovarian cancer; PARP inhibitors.

Publication types

Review

MeSH terms

Female
Humans
Maintenance Chemotherapy*
Ovarian Neoplasms / drug therapy*
Poly(ADP-ribose) Polymerase Inhibitors / therapeutic use*

Substances

Poly(ADP-ribose) Polymerase Inhibitors