PARP inhibitors in the Management of Ovarian Cancer: ASCO guideline
Open accessAbstract
PURPOSE To provide recommendations on the use of poly(ADP-ribose) polymerase inhibitors (PARPis) for management of epithelial ovarian, tubal, or primary peritoneal cancer (EOC). METHODS Randomized, controlled, and open-labeled trials published from 2011 through 2020 were identified in a literature search. Guideline recommendations were based on the review of the evidence, US Food and Drug Administration approvals, and consensus when evidence was lacking. RESULTS The systematic review identified 17 eligible trials. RECOMMENDATIONS The guideline pertains to patients who are PARPi naïve. All patients with newly diagnosed, stage III-IV EOC whose disease is in complete or partial response to first-line, platinum-based chemotherapy with high-grade serous or endometrioid EOC should be offered PARPi maintenance therapy with niraparib. For patients with germline or somatic pathogenic or likely pathogenic variants in BRCA1 (g/s BRCA1) or BRCA2 (g/s BRCA2) genes should be treated with olaparib. The addition of olaparib to bevacizumab may be offered to patients with stage III-IV EOC with g/s BRCA1/2 and/or genomic instability and a partial or complete response to chemotherapy plus bevacizumab combination. Maintenance therapy (second line or more) with single-agent PARPi may be offered for patients with EOC who have not received a PARPi and have responded to platinum-based therapy regardless of BRCA mutation status. Treatment with a PARPi should be offered to patients with recurrent EOC that has not recurred within 6 months of platinum-based therapy, who have not received a PARPi and have a g/s BRCA1/2, or whose tumor demonstrates genomic instability. PARPis are not recommended for use in combination with chemotherapy, other targeted agents, or immune-oncology agents in the recurrent setting outside the context of a clinical trial. Recommendations for managing specific adverse events are presented. Data to support reuse of PARPis in any setting are needed. Additional information is available at www.asco.org/gynecologic-cancer-guidelines .
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Participant eligibility criteria for patients on PARPi reflected clinical guidelines and the FDA approvals for PARPi at the time.
“our participant eligibility criteria for patients on PARPi reflected clinical guidelines and the FDA approvals for PARPi at the time [43].”
From Pilot randomized trial of an acceptance-based telehealth intervention for women with ovarian cancer and PARP inhibitor-related fatigue (2023) · cites this paper as [43]
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- Authors
- Tew, W. P., Lacchetti, C., Ellis, A., Maxian, K., Banerjee, S., Bookman, M., Jones, M. B., Lee, J.-M., Lheureux, S., Liu, J. F., Moore, K. N., Muller, C., Rodriguez, P., Walsh, C., Westin, S. N., & Kohn, E. C.
- Affiliations
- Memorial Sloan Kettering Cancer Center (US)
- American Society of Clinical Oncology (US)
- SHARE (US)
- Ovarian Cancer Project, Williamsville, NY
- Royal Marsden NHS Foundation Trust (GB)
- Kaiser Permanente (US)
- Anne Arundel Medical Center (US)
- National Institutes of Health (US)
- University Health Network (CA)
- Dana-Farber Cancer Institute (US)
- OU Health Stephenson Cancer Center (US)
- University of New Mexico (US)
- Virginia Cancer Specialists, Arlington, VA
- Cedars-Sinai Medical Center (US)
- The University of Texas MD Anderson Cancer Center (US)
- ORCID
- Venue
- Journal of Clinical Oncology
- Published
- 2020-10-20
- Volume
- 38
- Issue
- 30
- Pages
- 3468-3493
- ISSN
- 0732-183X (ISSN-L)
- 1527-7755
- PMC
- PMC8942301
- OpenAlex
- W3048967410
- Cited by
- 315
- References
- 41
- Citations by year
- 2026: 30 · 2025: 45 · 2024: 45 · 2023: 64 · 2022: 73 · 2021: 55 · 2020: 3
- FWCI
- 17.79
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Clinical Oncology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health
- National Cancer Institute (ZIABC011525)
- Topics
- Health Sciences › Medicine › Oncology › PARP inhibition in cancer therapy
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › BRCA gene mutations in cancer
- Health Sciences › Medicine › Reproductive Medicine › Ovarian cancer diagnosis and treatment
- Keywords
- PARP inhibitors, epithelial ovarian cancer, fallopian tube cancer, primary peritoneal cancer, maintenance therapy, recurrent ovarian cancer, BRCA1, BRCA2, olaparib, niraparib, bevacizumab, platinum-based chemotherapy, genomic instability, adverse events
- MeSH terms
- Poly(ADP-ribose) Polymerase Inhibitors, Carcinoma, Ovarian Epithelial, Female, Humans, Neoplasm Staging, Ovarian Neoplasms, Randomized Controlled Trials as Topic
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