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Review
. 2021 Mar 15;13(6):1298.
doi: 10.3390/cancers13061298.

Ovarian Cancer Treatments Strategy: Focus on PARP Inhibitors and Immune Check Point Inhibitors

Camilla Nero  1   2 , Francesca Ciccarone  1 , Antonella Pietragalla  1 , Simona Duranti  1 , Gennaro Daniele  1 , Vanda Salutari  3 , Maria Vittoria Carbone  3 , Giovanni Scambia  1   2 , Domenica Lorusso  1   2
Affiliations
Review

Ovarian Cancer Treatments Strategy: Focus on PARP Inhibitors and Immune Check Point Inhibitors

Camilla Nero et al. Cancers (Basel). .

Abstract

Ovarian cancer treatment strategy is mainly based on three pillars: cytoreductive surgery, platinum-based chemotherapy, and targeted therapies. The latter in the last decade has provided a remarkable improvement in progression free patients and, hopefully, in overall survival. In particular, poly(adenosine diphosphate-ribose) polymerase (PARP) inhibitors exploit BRCA 1/2 mutations and DNA damage response deficiencies, which are believed to concern up to 50% of high grade epithelial ovarian cancer cases. While these agents have an established role in ovarian cancer treatment strategy in BRCA mutated and homologous recombination deficient patients, an appropriate predictive molecular test to select patients is lacking in clinical practice. At the same time, the impressive results of immunotherapy in other malignancies, have opened the space for the introduction of immune-stimulatory drugs in ovarian cancer. Despite immune checkpoint inhibitors as a monotherapy bringing only modest efficacy when assessed in pretreated ovarian cancer patients, the combination with chemotherapy, anti-angiogenetics, PARP inhibitors, and radiotherapy is believed to warrant further investigation. We reviewed literature evidence on PARP inhibitors and immunotherapy in ovarian cancer treatment.

Keywords: PARP inhibitors; immunotherapy; ovarian cancer; targeted therapy.

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Conflict of interest statement

C.N. and F.C. have no conflict of interest to declare. A.P. worked at AstraZeneca Medical Affair Division from March 2015 until December 2018 and received personal fees from GSK for consulting. S.D. worked at AbbVie Medical Affair Division from July 2017 to March 2020. G.D. has served on advisory board of Beigene and received support for travel and accomodation from Roche. V.S. has served on advisory board of Roche, Astra Zeneca, MSD, GSK and Clovis and received support for travel and accomodation from Pharmamar, GSK, Roche. M.V.C. has no conflict of interest to declare. G.S. has served on advisory boards for TESARO Bio Italy S.r.l, Johnson & Johnson, Clovis Oncology Italy S.r.l. He received support for travel or accommodation from MSD Italy S.r.l and Clovis, Oncology Italy S.r.l, and institutional research funding from MSD Italy S.r.l. D.L. has served on advisory boards for Clovis Oncology, AstraZeneca, Genmab/Seattle Genetics, MSD, ImmunoGen, PharmaMar, Roche, and Tesaro/GSK, received support for travel or accommodation from AstraZeneca, GSK and Roche and institutional research funding from Merck, GSK, Clovis, Pharmamar.

Figures

Figure 1
Figure 1
(a). Determinants of forefront ovarian cancer (OC) therapeutic strategy. (b). Determinants of recurrent OC therapeutic strategy.
Figure 2
Figure 2
A timeline of targeted therapies approvals in OC by both the Food and Drug Administration (FDA) and European Medicines Agency (EMA).
Figure 3
Figure 3
Clinical trials in front line OC treatment: median progression-free survival (PFS) of approved agents.
Figure 4
Figure 4
Recurrent OC treatment: median PFS from clinical trials which lead to agent approval. *OS was the primary endpoint, but months reported express PFS for all trials in the figure. **ORR: Objective response rate.
See this image and copyright information in PMC

References

    1. Greenlee R.T., Hill-Harmon M.B., Murray T., Thun M. Cancer statistics, 2001. CA Cancer J. Clin. 2001;51:15–36. doi: 10.3322/canjclin.51.1.15. - DOI - PubMed
    1. Karam A., Ledermann J.A., Kim J.W., Sehouli J., Lu K., Gourley C., Katsumata N., Burger R.A., Nam B.H., Bacon M., et al. Fifth Ovarian Cancer Consensus Conference of the Gynecologic Cancer InterGroup: First-line interventions. Ann. Oncol. 2017;28:711e717. doi: 10.1093/annonc/mdx011. - DOI - PubMed
    1. Wilson M.K., Pujade-Lauraine E., Aoki D., Mirza M.R., Lorusso D., Oza A.M., du Bois A., Vergote I., Reuss A., Bacon M., et al. Ochiai, and on behalf of the participants of the Fifth Ovarian Cancer Consensus Conference Fifth Ovarian Cancer Consensus Conference of the Gynecologic Cancer InterGroup: Recurrent disease. Ann. Oncol. 2017;28:727–732. doi: 10.1093/annonc/mdw663. - DOI - PMC - PubMed
    1. Wang Q., Peng H., Qi X., Wu M., Zhao X. Targeted therapies in gynecological cancers: A comprehensive review of clinical evidence. Signal Transduct Target Ther. 2020;5:137. doi: 10.1038/s41392-020-0199-6. - DOI - PMC - PubMed
    1. Colombo N., Sessa C., Du Bois A., Ledermann J., McCluggage W.G., McNeish I., Morice P., Pignata S., Ray-Coquard I., Vergote I., et al. ESMO-ESGO Ovarian Cancer Consensus Conference Working Group ESMO-ESGO consensus conference recommendations on ovarian cancer: Pathology and molecular biology, early and advanced stages, borderline tumours and recurrent disease. Ann. Oncol. 2019;30:672–705. doi: 10.1093/annonc/mdz062. - DOI - PubMed

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