PARP Inhibitor Maintenance After First-Line Chemotherapy in Advanced-Stage Epithelial Ovarian Cancer

What is the association of first-line poly(adenosine diphosphate-ribose) polymerase inhibitor (PARP inhibitor) maintenance therapy with survival outcomes in epithelial ovarian cancer, and how do outcomes vary across regimens and subgroups?In this meta-analysis of 7 randomized clinical trials among 4013 patients with advanced-stage epithelial ovarian cancer responding to first-line platinum-based chemotherapy, progression-free survival improved in most subgroups but not in homologous recombination-proficient tumors, and no subgroup demonstrated a statistically significant overall survival benefit. Efficacy and toxic effects varied across agents.This study found that first-line PARP inhibitor maintenance therapy was associated with a progression-free survival benefit in many patient populations; however, the lack of overall survival benefit, increased toxic effects, and variability across subgroups and regimens, suggest that treatment should be individualized.

Corresponding Author: Tibor A. Zwimpfer, MD, Gynaecological Cancer Centre, University Hospital Basel, Spitalstrasse 21, 4031 Basel, Switzerland (tibor.zwimpfer@usb.ch); Stamatios Petousis, PhD, MD, Second Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Greece, Konstantinoupoleos 49, 54624, Thessaloniki, Greece (petousisstamatios@gmail.com).

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