Book contents
- 50 Big Debates in Gynecologic Oncology
- 50 Big Debates in Gynecologic Oncology
- Copyright page
- Contents
- Contributors
- Section I Perioperative Management
- Section II Screening, Prevention, and Early Diagnosis
- Section III Ovarian Cancer
- Debate 5A Should CA-125 Surveillance be Performed after Completion of Primary Treatment for Ovarian Cancer Patients in Remission?
- Debate 5B Should CA-125 Surveillance be Performed after Completion of Primary Treatment for Ovarian Cancer Patients in Remission?
- Chapter 6A In Patients with BRCA-negative and HRD-negative Epithelial Ovarian Cancer, Should Molecular Profiling be Routinely Done to Guide Adjuvant Therapy?
- Debate 6B In Patients with BRCA-negative and HRD-negative Epithelial Ovarian Cancer, Should Molecular Profiling be Routinely Done to Guide Adjuvant Therapy?
- Debate 7A Is MEK Inhibitor Therapy the Best Treatment Recommendation for Low-Grade Serous Ovarian Cancer Patients at First Relapse?
- Debate 7B Is MEK Inhibitor Therapy the Best Treatment Recommendation for Low-Grade Serous Ovarian Cancer Patients at First Relapse?
- Debate 8A Should Stage IC Mucinous Ovarian Carcinoma be Managed by Observation or Adjuvant Chemotherapy?
- Debate 8B Should Stage IC Mucinous Ovarian Carcinoma be Managed by Observation or Adjuvant Chemotherapy?
- Debate 9A How Many Cycles of Adjuvant Chemotherapy Should be Administered to Patients with High-risk Stage I Epithelial Ovarian Cancer?
- Debate 9B How Many Cycles of Adjuvant Chemotherapy Should be Administered to Patients with High-risk Stage I Epithelial Ovarian Cancer?
- Debate 10A Patients with Advanced Ovarian Cancer who are 75 Years Old and Above Should Routinely be Treated with Neoadjuvant Chemotherapy?
- Debate 10B Patients with Advanced Ovarian Cancer who are 75 Years Old and Above Should Routinely be Treated with Neoadjuvant Chemotherapy?
- Debate 11A Should an Attempt at Aggressive Cytoreduction be Made for all Surgical Candidates with Advanced Ovarian Cancer prior to Treatment with Adjuvant Chemotherapy?
- Debate 11B Should an Attempt at Aggressive Cytoreduction be Made for all Surgical Candidates with Advanced Ovarian Cancer prior to Treatment with Adjuvant Chemotherapy?
- Debate 12A Should Minimally Invasive Modalities be Routinely/Uniformly Utilized for Assessment of Resectability prior to Attempted Primary Debulking in Patients with Advanced Ovarian Cancer?
- Debate 12B Should Laparoscopic Modalities be Routinely Utilized for Assessment of Resectability prior to Attempted Primary Debulking in Patients with Advanced Ovarian Cancer?
- Debate 13A Should Enlarged Supradiaphragmatic Lymph Nodes be Routinely Removed during Debulking Surgery Procedures for Patients with Advanced Ovarian Cancer?
- Debate 13B Should Enlarged Supradiaphragmatic Lymph Nodes be Routinely Removed during Debulking Surgery Procedures for Patients with Advanced Ovarian Cancer?
- Debate 14A Is there a Role for Hyperthermic Intraperitoneal Chemotherapy in Front-line Therapy for Ovarian Cancer?
- Debate 14B Is there a Role for Hyperthermic Intraperitoneal Chemotherapy in Front-line Therapy for Ovarian Cancer?
- Debate 15A Is there a Role for Intraperitoneal Chemotherapy after Optimal Cytoreduction of Ovarian Cancer?
- Debate 15B Is there a Role for Intraperitoneal Chemotherapy after Optimal Cytoreduction of Ovarian Cancer?
- Debate 16A What is the Best Front-line Maintenance Therapy for HRD-positive Ovarian Cancer?
- Debate 16B What is the Best Front-line Maintenance Therapy for HRD-positive Ovarian Cancer?
- Debate 17A When is the Best Time to Use PARP Inhibitors for Maintenance?
- Debate 17B When is the Best Time to Use PARP Inhibitors for Maintenance?
- Debate 18A What is the best front-line maintenance therapy for optimally debulked HRD-negative advanced epithelial ovarian cancer? Bevacizumab
- Debate 18B What is the best front-line maintenance therapy for optimally debulked HRD-negative advanced epithelial ovarian cancer?
- Debate 19A What is the Optimal Therapeutic Option for Platinum-resistant Recurrent Ovarian Cancer
- Debate 19B What is the Optimal Therapeutic Option for Platinum-resistant Recurrent Ovarian Cancer?
- Debate 20A Should Patients with Platinum-sensitive Recurrent Ovarian Cancer Undergo Secondary Cytoreduction prior to Receiving Platinum-containing Second-line Chemotherapy?
- Debate 20B Should All Patients with Platinum-sensitive Recurrent Ovarian Cancer be Considered for Secondary Cytoreduction prior to Receiving Second-line Platinum Chemotherapy?
- Debate 21A Should Tertiary Debulking for Patients with Recurrent Ovarian Cancer be Performed?
- Debate 21B Should Tertiary Debulking be Performed for Patients with Recurrent Ovarian Cancer?
- Debate 22A Is there a Role for Immunotherapy in Ovarian Cancer?
- Debate 22B Is there a Role for Immunotherapy in Ovarian Cancer?
- Debate 23A What is the Best Management Option for Malignant Bowel Obstruction?
- Debate 23B What is the Best Management Option for Malignant Bowel Obstruction?
- Debate 24A What is the Optimal Chemotherapy Regimen for Ovarian Germ-cell Tumors?
- Debate 24B What is the Optimal Chemotherapy Regimen for Ovarian Germ-cell Tumors?
- Debate 25A What is the Optimal Adjuvant Chemotherapy Regimen for Primary Granulosa Cell Tumor?
- Debate 25B What is the Optimal Adjuvant Chemotherapy Regimen for Primary Granulosa Cell Tumor?
- Debate 26A What is the Best Management Strategy for a Recurrent Granulosa Cell Tumor?
- Debate 26B What is the Best Management Strategy for Recurrent Granulosa Cell Tumor?
- Debate 27A Is progression-free survival a rational surrogate endpoint in front-line ovarian cancer clinical trials?
- Debate 27B Is progression-free survival a rational surrogate endpoint in front-line ovarian cancer clinical trials?
- Section IV Endometrial Cancer
- Section V Cervical Cancer
- Section VI Vaginal and Vulvar Cancer
- Index
- References
Debate 17A - When is the Best Time to Use PARP Inhibitors for Maintenance?
Front-line
from Section III - Ovarian Cancer
Published online by Cambridge University Press: 20 July 2023
Book contents
- 50 Big Debates in Gynecologic Oncology
- 50 Big Debates in Gynecologic Oncology
- Copyright page
- Contents
- Contributors
- Section I Perioperative Management
- Section II Screening, Prevention, and Early Diagnosis
- Section III Ovarian Cancer
- Debate 5A Should CA-125 Surveillance be Performed after Completion of Primary Treatment for Ovarian Cancer Patients in Remission?
- Debate 5B Should CA-125 Surveillance be Performed after Completion of Primary Treatment for Ovarian Cancer Patients in Remission?
- Chapter 6A In Patients with BRCA-negative and HRD-negative Epithelial Ovarian Cancer, Should Molecular Profiling be Routinely Done to Guide Adjuvant Therapy?
- Debate 6B In Patients with BRCA-negative and HRD-negative Epithelial Ovarian Cancer, Should Molecular Profiling be Routinely Done to Guide Adjuvant Therapy?
- Debate 7A Is MEK Inhibitor Therapy the Best Treatment Recommendation for Low-Grade Serous Ovarian Cancer Patients at First Relapse?
- Debate 7B Is MEK Inhibitor Therapy the Best Treatment Recommendation for Low-Grade Serous Ovarian Cancer Patients at First Relapse?
- Debate 8A Should Stage IC Mucinous Ovarian Carcinoma be Managed by Observation or Adjuvant Chemotherapy?
- Debate 8B Should Stage IC Mucinous Ovarian Carcinoma be Managed by Observation or Adjuvant Chemotherapy?
- Debate 9A How Many Cycles of Adjuvant Chemotherapy Should be Administered to Patients with High-risk Stage I Epithelial Ovarian Cancer?
- Debate 9B How Many Cycles of Adjuvant Chemotherapy Should be Administered to Patients with High-risk Stage I Epithelial Ovarian Cancer?
- Debate 10A Patients with Advanced Ovarian Cancer who are 75 Years Old and Above Should Routinely be Treated with Neoadjuvant Chemotherapy?
- Debate 10B Patients with Advanced Ovarian Cancer who are 75 Years Old and Above Should Routinely be Treated with Neoadjuvant Chemotherapy?
- Debate 11A Should an Attempt at Aggressive Cytoreduction be Made for all Surgical Candidates with Advanced Ovarian Cancer prior to Treatment with Adjuvant Chemotherapy?
- Debate 11B Should an Attempt at Aggressive Cytoreduction be Made for all Surgical Candidates with Advanced Ovarian Cancer prior to Treatment with Adjuvant Chemotherapy?
- Debate 12A Should Minimally Invasive Modalities be Routinely/Uniformly Utilized for Assessment of Resectability prior to Attempted Primary Debulking in Patients with Advanced Ovarian Cancer?
- Debate 12B Should Laparoscopic Modalities be Routinely Utilized for Assessment of Resectability prior to Attempted Primary Debulking in Patients with Advanced Ovarian Cancer?
- Debate 13A Should Enlarged Supradiaphragmatic Lymph Nodes be Routinely Removed during Debulking Surgery Procedures for Patients with Advanced Ovarian Cancer?
- Debate 13B Should Enlarged Supradiaphragmatic Lymph Nodes be Routinely Removed during Debulking Surgery Procedures for Patients with Advanced Ovarian Cancer?
- Debate 14A Is there a Role for Hyperthermic Intraperitoneal Chemotherapy in Front-line Therapy for Ovarian Cancer?
- Debate 14B Is there a Role for Hyperthermic Intraperitoneal Chemotherapy in Front-line Therapy for Ovarian Cancer?
- Debate 15A Is there a Role for Intraperitoneal Chemotherapy after Optimal Cytoreduction of Ovarian Cancer?
- Debate 15B Is there a Role for Intraperitoneal Chemotherapy after Optimal Cytoreduction of Ovarian Cancer?
- Debate 16A What is the Best Front-line Maintenance Therapy for HRD-positive Ovarian Cancer?
- Debate 16B What is the Best Front-line Maintenance Therapy for HRD-positive Ovarian Cancer?
- Debate 17A When is the Best Time to Use PARP Inhibitors for Maintenance?
- Debate 17B When is the Best Time to Use PARP Inhibitors for Maintenance?
- Debate 18A What is the best front-line maintenance therapy for optimally debulked HRD-negative advanced epithelial ovarian cancer? Bevacizumab
- Debate 18B What is the best front-line maintenance therapy for optimally debulked HRD-negative advanced epithelial ovarian cancer?
- Debate 19A What is the Optimal Therapeutic Option for Platinum-resistant Recurrent Ovarian Cancer
- Debate 19B What is the Optimal Therapeutic Option for Platinum-resistant Recurrent Ovarian Cancer?
- Debate 20A Should Patients with Platinum-sensitive Recurrent Ovarian Cancer Undergo Secondary Cytoreduction prior to Receiving Platinum-containing Second-line Chemotherapy?
- Debate 20B Should All Patients with Platinum-sensitive Recurrent Ovarian Cancer be Considered for Secondary Cytoreduction prior to Receiving Second-line Platinum Chemotherapy?
- Debate 21A Should Tertiary Debulking for Patients with Recurrent Ovarian Cancer be Performed?
- Debate 21B Should Tertiary Debulking be Performed for Patients with Recurrent Ovarian Cancer?
- Debate 22A Is there a Role for Immunotherapy in Ovarian Cancer?
- Debate 22B Is there a Role for Immunotherapy in Ovarian Cancer?
- Debate 23A What is the Best Management Option for Malignant Bowel Obstruction?
- Debate 23B What is the Best Management Option for Malignant Bowel Obstruction?
- Debate 24A What is the Optimal Chemotherapy Regimen for Ovarian Germ-cell Tumors?
- Debate 24B What is the Optimal Chemotherapy Regimen for Ovarian Germ-cell Tumors?
- Debate 25A What is the Optimal Adjuvant Chemotherapy Regimen for Primary Granulosa Cell Tumor?
- Debate 25B What is the Optimal Adjuvant Chemotherapy Regimen for Primary Granulosa Cell Tumor?
- Debate 26A What is the Best Management Strategy for a Recurrent Granulosa Cell Tumor?
- Debate 26B What is the Best Management Strategy for Recurrent Granulosa Cell Tumor?
- Debate 27A Is progression-free survival a rational surrogate endpoint in front-line ovarian cancer clinical trials?
- Debate 27B Is progression-free survival a rational surrogate endpoint in front-line ovarian cancer clinical trials?
- Section IV Endometrial Cancer
- Section V Cervical Cancer
- Section VI Vaginal and Vulvar Cancer
- Index
- References
Summary
The development and use of Poly(ADP-ribose) polymerase inhibitors (PARPi) in advanced ovarian cancer (OC) have been an incredible clinical breakthrough. PARPi are FDA-approved as front-line maintenance for BRCA1-/2- associated (olaparib or niraparib), homologous recombination deficient (HRD) (niraparib or olaparib with bevacizumab), and homologous recombination proficient (HRP) (niraparib) advanced-stage high-grade ovarian cancer (HGOC). Along with a third PARPi, rucaparib, they are also approved following recurrence as both maintenance and treatment. Here we advocate for PARPi as front-line maintenance for BRCA1-/2- associated (germline or somatic) and HRD tumors. We also discuss our recommendations for patients with HRP tumors.
- Type
- Chapter
- Information
- 50 Big Debates in Gynecologic Oncology , pp. 95 - 97Publisher: Cambridge University PressPrint publication year: 2023
References
Moore, K, et al. Maintenance olaparib in patients with newly diagnosed advanced ovarian cancer. N Engl J Med 2018;379(26):2495–2505.CrossRefGoogle ScholarPubMed
Ray-Coquard, I, et al. Olaparib plus bevacizumab as first-line maintenance in ovarian cancer. N Engl J Med 2019;381(25):2416–2428.CrossRefGoogle ScholarPubMed
Gonzalez-Martin, A, et al. Niraparib in patients with newly diagnosed advanced ovarian cancer. N Engl J Med 2019;381(25):2391–2402.CrossRefGoogle ScholarPubMed
Poveda, A, et al. Olaparib tablets as maintenance therapy in patients with platinum-sensitive relapsed ovarian cancer and a BRCA1/2 mutation (SOLO2/ENGOT-Ov21): a final analysis of a double-blind, randomised, placebo-controlled, phase 3 trial. Lancet Oncol 2021;22(5):620–631.CrossRefGoogle Scholar
Moore, KN, et al. Niraparib monotherapy for late-line treatment of ovarian cancer (QUADRA): a multicentre, open-label, single-arm, phase 2 trial. Lancet Oncol 2019;20(5):636–648.CrossRefGoogle Scholar