Centre de Recherche en Cancérologie de Lyon, UMR Inserm 1052, CNRS 5286, Centre Léon Bérard, Lyon, 69008, France.
Department of Medical Oncology, Centre Léon Bérard, 28 Prom. Léa et Napoléon Bullukian, Lyon, 69008, France.
Future Oncol. 2021 Jun;17(18):2291-2304. doi: 10.2217/fon-2021-0059. Epub 2021 Mar 17.
Homologous recombination deficiency and VEGF expression are key pathways in high-grade ovarian cancer. Recently, three randomized practice changing trials were published: the PAOLA-1, PRIMA and VELIA trials. The use of PARP inhibitors (PARPi) following chemotherapy has become standard of care in first line. Combination of PARPi with anti-angiogenic agents has demonstrated synergistic activity in preclinical study. This review summarizes the body of evidence supporting the efficacy and safety of the combination of PARPi and anti-angiogenic drugs in first-line homologous recombination deficiency high-grade ovarian cancer leading to US FDA and EMA approvals. This double maintenance is supported by: a large benefit with bevacizumab + olaparib compared with olaparib alone, a rationale for additive effect, and a good safety and cost-effective profile.
同源重组缺陷和血管内皮生长因子表达是高级别卵巢癌的关键途径。最近，三项随机对照临床试验（PAOLA-1、PRIMA 和 VELIA 试验）发表。化疗后使用聚腺苷二磷酸核糖聚合酶（PARP）抑制剂（PARPi）已成为一线治疗的标准。PARPi 与抗血管生成药物联合使用在临床前研究中显示出协同作用。这篇综述总结了支持 PARPi 和抗血管生成药物联合应用于一线同源重组缺陷高级别卵巢癌的疗效和安全性的证据，这一联合治疗已获得美国 FDA 和欧洲药品管理局的批准。这种双重维持的依据是：贝伐珠单抗联合奥拉帕利治疗比单独使用奥拉帕利有更大的获益，具有累加效应的理论基础，以及良好的安全性和成本效益。
