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So it’s actually been a very exciting time in the last couple of years. For the longest time. You know, in ovarian cancer patients, we did a very good job of enabling the disease to be put into remission.
However, regrettably, remission didn’t last long. And now in the current scheme of things, patients that do relapse with ovarian cancer, are able to undergo chemotherapy. And if in essence, they’ve achieved a complete or partial response, we now can maintain that response by some of these new drugs.
Ovarian cancer Overview
“Ovarian cancer is a type of cancer that begins in the ovaries. The female reproductive system contains two ovaries, one on each side of the uterus. The ovaries — each about the size of an almond — produce eggs (ova) as well as the hormones estrogen and progesterone.
Ovarian cancer often goes undetected until it has spread within the pelvis and abdomen. At this late stage, ovarian cancer is more difficult to treat. Early-stage ovarian cancer, in which the disease is confined to the ovary, is more likely to be treated successfully.
Surgery and chemotherapy are generally used to treat ovarian cancer.”
PARP inhibitors vs Ovarian Cancer
These new drugs are called the PARP inhibitors . And we’re lucky enough now to have three of those drugs that can actually help us in the ovarian cancer arena. One of them is Olaparib. One of them is Rucaparib , and one of them is Niraparib. And through a whole series of very different studies, however, all studies have actually shown as a benefit in terms of maintenance, we’ve been able to actually prolong the median progression free survival of women with ovarian cancer, which is monumental, it’s something that we did not have many years ago.
So we do have learned a lot about these particular drugs, these drugs, have certain toxicities, and we’ve been learning to actually modify some of these toxicities, looking at making sure that their blood counts are adequate, that their liver function tests are monitored, the GI tract is actually working nicely.
Final thoughts about PARP inhibitors and ovarian cancer:
Overall, we’ve seen in these group of women is that by giving them these pills, and they are oral medications, that we can actually improve progression free survival, what we have yet to know is whether or not we improve overall survival. This is markedly different than several years ago when we used to use chemotherapy as maintenance and one of the changes in the NCCN guidelines is to do away with for example, Taxol as a maintenance, which didn’t seem to prove to be very efficacious, but with the institution of these drugs, I think it’s a very exciting time and certainly will chance to change the landscape of women with ovarian cancer.
Any thoughts about the subject? Feel free to comment!
Cook SA, Tinker AV. PARP Inhibitors and the Evolving Landscape of Ovarian Cancer Management: A Review. BioDrugs. 2019 Jun;33(3):255-273. doi: 10.1007/s40259-019-00347-4. PMID: 30895466.