Stephenson Cancer Center at the University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA.
Curr Opin Obstet Gynecol. 2019 Feb;31(1):4-11. doi: 10.1097/GCO.0000000000000507.
This review will provide an update of recently presented clinical data as well as discuss ongoing trials focused on the incorporation of poly (ADP-ribose) polymerase inhibitors (PARPi) into the treatment paradigm for ovarian cancer.
As of this publication, PARPi have indications in many parts of the globe as maintenance therapy following response to platinum-based chemotherapy in the setting of platinum-sensitive recurrence. In addition, in the United States, two PARPi have indications as monotherapy treatment for recurrent ovarian cancer in patients with a BRCA mutation and at least two prior lines of therapy. Exciting data was published in October 2018, demonstrating an unprecedented benefit to utilization of olaparib following response to front-line platinum-based chemotherapy among patients with a BRCA mutation and this data is expected to expand the indication for olaparib globally.
Ongoing studies will seek to expand the benefit of PARPi beyond the BRCA population in front-line therapy as well as to overcome inherent and acquired resistance to PARPi with studies of novel combinations with antiangiogenesis agents, immune-oncology agents and chemotherapy. These efforts may identify more settings and populations in which PARPi provide clinical benefit.
目的综述：本篇综述将更新近期发表的临床数据，并讨论正在进行的临床试验，这些试验集中于将聚（ADP-核糖）聚合酶抑制剂（PARPi）纳入卵巢癌的治疗模式。
最新发现：截至本出版物，PARPi 在全球许多地区都有适应证，作为铂类敏感复发性疾病对铂类化疗反应后的维持治疗。此外，在美国，两种 PARPi 作为有 BRCA 突变和至少两种既往治疗线的复发性卵巢癌患者的单药治疗有适应证。2018 年 10 月发表了令人兴奋的数据，证明在 BRCA 突变患者中，在前一线铂类化疗后使用奥拉帕利获益前所未有，预计该数据将在全球范围内扩大奥拉帕利的适应证。
总结：正在进行的研究将寻求将 PARPi 的获益扩展到一线治疗中的 BRCA 人群之外，并通过与抗血管生成药物、免疫肿瘤学药物和化疗的新型联合研究来克服 PARPi 的内在和获得性耐药。这些努力可能会确定更多的 PARPi 提供临床获益的情况和人群。
