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卵巢癌的靶向治疗:PARP抑制剂应用的快速演变格局

Targeted therapy for ovarian cancer: the rapidly evolving landscape of PARP inhibitor use.

作者信息

Walsh Christine

机构信息

Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, CA, USA -

出版信息

Minerva Ginecol. 2018 Apr;70(2):150-170. doi: 10.23736/S0026-4784.17.04152-1. Epub 2017 Oct 9.

Abstract

INTRODUCTION

Poly(ADP-ribose) polymerase (PARP) inhibitors are a targeted therapy option for ovarian cancer. The goal of this review was to organize and summarize the clinical trials evaluating PARP inhibitor therapy in ovarian cancer as monotherapy, maintenance therapy after partial or complete remission to therapy or as a part of a combination regimen.

EVIDENCE ACQUISITION

PubMed, ClinicalTrials.gov, data from the United States Food and Drug Administration (US FDA) and proceedings from scientific conferences were searched for published and unpublished data pertaining to clinical trials and approvals of PARP inhibitor use in ovarian cancer.

EVIDENCE SYNTHESIS

There have been 36 published phase 1, 2 and 3 studies evaluating the use of olaparib, niraparib, veliparib and rucaparib in ovarian cancer. Olaparib and rucaparib have been approved by the US FDA as monotherapy for advanced recurrent ovarian cancer. Niraparib and olaparib have been approved by the US FDA for maintenance therapy after partial or complete remission in recurrent ovarian cancer. There are currently ten phase 3 trials evaluating PARP inhibitors at various timepoints in ovarian cancer therapy including at the time of primary adjuvant therapy, as maintenance therapy after primary chemotherapy, as monotherapy for recurrent cancer and as maintenance therapy after chemotherapy for recurrence.

CONCLUSIONS

The landscape of PARP inhibitor use for ovarian cancer is rapidly evolving and PARP inhibitors have become more available as a targeted therapy option for ovarian cancer treatment.

摘要

引言

聚(ADP - 核糖)聚合酶(PARP)抑制剂是卵巢癌的一种靶向治疗选择。本综述的目的是整理和总结评估PARP抑制剂作为单药治疗、部分或完全缓解后作为维持治疗或作为联合治疗方案一部分用于卵巢癌治疗的临床试验。

证据获取

检索了PubMed、ClinicalTrials.gov、美国食品药品监督管理局(US FDA)的数据以及科学会议的会议记录,以获取与PARP抑制剂用于卵巢癌的临床试验和批准相关的已发表和未发表数据。

证据综合

已有36项发表的1期、2期和3期研究评估了奥拉帕尼、尼拉帕尼、维利帕尼和鲁卡帕尼在卵巢癌中的应用。奥拉帕尼和鲁卡帕尼已被美国食品药品监督管理局批准作为晚期复发性卵巢癌的单药治疗。尼拉帕尼和奥拉帕尼已被美国食品药品监督管理局批准用于复发性卵巢癌部分或完全缓解后的维持治疗。目前有10项3期试验在卵巢癌治疗的不同时间点评估PARP抑制剂,包括在初次辅助治疗时、初次化疗后作为维持治疗、作为复发性癌症的单药治疗以及化疗复发后作为维持治疗。

结论

PARP抑制剂用于卵巢癌的情况正在迅速发展,PARP抑制剂已成为卵巢癌治疗中更易获得的靶向治疗选择。

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