At ESMO Congress 2019, Mansoor Raza Mirza, MD, chief oncologist at Copenhagen University Hospital, discussed the latest practice-changing clinical data results involving PARP inhibitor therapy in ovarian cancer. 


PARP [poly ADP ribose polymerase] inhibitors have already completely changed the landscape in the maintenance therapy. The treatment has become so better. The question is why they have to relapse to get PARP inhibitors. That’s why the SOLO-1 data which was presented last year, only in 20% of the patients who had BRCA mutation showed unprecedented efficacy.

In this ESMO, we are changing the history of ovarian cancer patients. Their standard of care will be completely changed because we have presented 3 very important phase 3 trials in first line with PARP inhibitors. There are some differences between them, but all in all, it looks very clear that there is a very strong clinical benefit in all 3 trials in the BRCA mutation population. But then when it comes to the HR-deficient BRCA wild, 2 of the 3 trials are positive. That is the trial PRIMA, which is niraparib alone as a maintenance, or PAOLA, which is olaparib plus bevacizumab. When it comes to HR-proficient disease, we see that one trial is clinically significant. That is PRIMA trial with monotherapy of niraparib as maintenance therapy. That means that today, we can change the practice and all patients in first line after receiving chemotherapy can receive a PARP inhibitor and will have a substantial benefit of that not progressing for a very long time. And probably that will transfer into survival benefit.