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Case Reports
. 2021 Jan 11:35:100699.
doi: 10.1016/j.gore.2021.100699. eCollection 2021 Feb.

PARPi after PARPi in epithelial ovarian cancer

K G Essel  1 , K Behbakht  2 , T Lai  3 , L Hand  4 , E Evans  1 , J Dvorak  1 , K Ding  1 , G Konecny  3 , K N Moore  5
Affiliations
Case Reports

PARPi after PARPi in epithelial ovarian cancer

K G Essel et al. Gynecol Oncol Rep. .

Abstract

The objective of this study was to describe the treatment experience of patients with recurrent epithelial ovarian cancer who are retreated with an inhibitor of poly(ADP-ribose)-polymerase (PARPi). We conducted a multi-institutional, retrospective review of ovarian cancer patients who received ≥2 lines of therapy containing a PARPi. Demographic, clinical, and pathological data were analyzed with descriptive statistics. Twenty-two patients were identified. For initial PARPi (PARPi1), 12 patients (54.5%) received veliparib, 7 (31.8%) olaparib and 3 (13.6%) rucaparib resulting in 10 patients who had no evidence of disease at the completion of therapy (NED), 3 partial responses (PR), 4 stable disease (SD), and 3 progressive disease (PD). (All 10 CRs involved veliparib given in conjunction with cytotoxic chemotherapy). PARPi1 was used as maintenance in 2 patients. PARPi1 was discontinued because planned number of cycles was reached (n = 10), progression (n = 8), toxicity (n = 2), other (n = 2). For second PARPi (PARPi2), 10 patients (45.4%) received niraparib, 6 (27.3%) olaparib, and 6 (27.3%) rucaparib resulting in 3 PR, 13 SD, and 3 PD. PARPi2 was used as maintenance in 3 patients. The 3 patients who experienced a PR to PARPi2 had a BRCA mutation and were NED following PARPi1. PARPi2 was discontinued because of progression (n = 13), toxicity (n = 6), other (n = 2). One patient currently remains on PARPi2. Toxicity after PARPi1 was not associated with toxicity from PARPi2 (p > 0.05). With 3 approved PARPi for different indications including frontline and recurrence, the opportunity to reuse PARPi has increased. Characterizing those who should be re-challenged is an important initiative moving forward.

Keywords: Ovarian cancer; PARP inhibitor.

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Conflict of interest statement

The authors wish to report that there is no conflict of interest to disclose with the following exceptions: KG Essel reports that she is a former shareholder of Johnson & Johnson. GE Konecny has served on speakers bureaus for AstraZeneca and Clovis Oncology; has received research funding from Amgen and Merck; and has received honorarium from Novartis. KN Moore reports personal fees and other from Astra Zeneca, grants, personal fees and other from Genentech/Roche, grants, personal fees and other from Immunogen, grants, personal fees and other from Clovis, grants, personal fees and other from Tesaro, personal fees and other from Pfizer, personal fees from Janssen, personal fees from Aravive, personal fees from VBL Therapeutics, personal fees and other from Onco Med, personal fees from Samumed, grants and other from Lilly, personal fees from Eisai, outside the submitted work.

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