Second-line Maintenance Therapy in Ovarian Cancer: PARP Inhibitors - Episode 5

ARIEL3 Trial: Exploratory Analysis Data

Bhavesh Shah, RPh, BCOP, reviews data and results from the ARIEL3 trial that studied the PARP inhibitor, rucaparib, for the management of ovarian cancer.

Bhavesh Shah, RPh, BCOP:We’ve seen some data out there recently at ASCO [American Society of Clinical Oncology Annual Meeting]. ARIEL3 had an analysis of the data. For those who may not be familiar with ARIEL3, it was a rucaparib phase 3 randomized controlled trial vs placebo. A recent analysis was done for that trial to see if there were any clinical or molecular characteristics that were more favorable for patients on rucaparib. We found that there were patients with BRCA wild type, which we know, and other known mechanisms of PARP inhibitors were more sensitive and had a favorable response and progression-free survival. I don’t know if there’s anything else you wanted to add to that; that’s my reading. Also, we’re so evolved in molecular characteristics. We can look at these things at a more granular level. Where is there anything that may be more favorable? There are many mutations and drivers that could be somewhat favorable or somewhat not favorable.

Thomasina Morris, RPh, MHA, BCOP: It comes into play when you mentioned that exceptional benefit analysis of the rucaparib. It takes the BRCA mutation and the BRCA wild type—RAD51 is 1 of the wild types—and they still showed benefit. Just to give you a sense looking at that sub: it looked at people who were progression-free survival greater than 2 years while on the rucaparib, and short term on patients who progressed in less than 12 weeks from the time they were initially started on treatment. It gives you a sense that we still have the opportunity for wild type. We still have the opportunity for BRCA mutation, as an opportunity for these patients to have a progression-free survival. We’re not seeing overall survival right now, so we’re going to take what we can get.

To add to that, the biggest challenge [is that] we have the PARP inhibitors, so we’re doing the best we can to get the right PARP to the right patient. Now we’re seeing patients who have been on PARPs for 3 to 4 years and getting resistance. Either they are progressing on a PARP inhibitor, have the BRCA mutation, have the HR [hormone receptor]–deficient mutation, or all of that, but it’s not lasting long enough.

This transcript has been edited for clarity.