Recurrent Ovarian Cancer with BRCAness Phenotype: A Treatment Challenge

Adv Ther. 2022 Nov;39(11):5289-5299. doi: 10.1007/s12325-022-02259-2. Epub 2022 Sep 5.

Abstract

Introduction: Ovarian cancer is a leading cause of death among women with gynecologic malignancies. The relapse rate is high after platinum-based therapy, with the effectiveness of subsequent treatment lines decreasing over time. Recent data suggest the benefit of maintenance therapy with niraparib in platinum-sensitive recurrent disease.

Case presentations: We report a case series of five women with advanced ovarian cancer and BRCAness phenotype who responded favorably, and in some cases with long-term response, to maintenance therapy with niraparib. Toxicities were as expected and generally manageable. Two patients developed grade 2/3 hematological toxicity, which resolved with treatment suspension and subsequent dose reductions, and one patient reported a rare skin toxicity while responding to full-dose niraparib treatment, which was controlled with photoprotection and sunscreen.

Discussion and conclusions: This case series highlights the role of PARP1/2 inhibitors as a new standard of care as maintenance therapy for recurrent platinum-sensitive high-grade ovarian cancer, irrespective of BRCA status.

Keywords: Advanced ovarian cancer; BRCAness; Maintenance therapy; PARP1/2 inhibitor; Platinum-sensitive.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Carcinoma, Ovarian Epithelial
  • Female
  • Humans
  • Neoplasm Recurrence, Local / drug therapy
  • Ovarian Neoplasms* / drug therapy
  • Ovarian Neoplasms* / pathology
  • Phenotype
  • Poly(ADP-ribose) Polymerase Inhibitors* / therapeutic use
  • Sunscreening Agents / therapeutic use

Substances

  • Poly(ADP-ribose) Polymerase Inhibitors
  • Sunscreening Agents