PARP inhibitor rechallenge plus bevacizumab in ovarian cancer

rechallenge with the PARP inhibitor niraparib in combination with bevacizumab as maintenance therapy has been shown promising efficacy in patients with ovarian cancer previously treated with a PARP inhibitor, as recently published on Clinical Cancer Research.

In the KGOG 3056/NIRVANA-R phase II trial 44 patients with platinum-sensitive recurrent ovarian cancer who had received ≥2 prior lines of platinum-based chemotherapy and prior PARP inhibitors maintenance received daily niraparib and triweekly bevacizumab until disease progression or unacceptable toxicity. Results showed that 59.1% of patients remained progression-free at 6 months, with an estimated progression-free survival rate of 68%.  Higher 6-months progression-free survival rates were observed in patients with a longer treatment-free interval after the penultimate chemotherapy and in those who achieved a complete response to the most recent chemotherapy. The NIRVANA-R study’s safety prole demonstrated manageable adverse events that were similar to those reported in other studies involving PARP inhibitora rechallenge or PARPinhibitors-bevacizumab combinations Authors poit out that the trial « did not meet its predefined primary endpoint, but provides important insights into the potential role of PARP inhibitors rechallenge with bevacizumab as a maintenance therapy in patients with platinum-sensitive recurrent ovarian cancer who were previously been treated with a PARP inhibitors. The study raises important questions about the impact of historical PARP inhibitors exposure and the timing of progression on the efficacy of rechallenge, underscoring the need for further research to refine patient selection and optimize treatment strategies. Overall, while the combination of niraparib and bevacizumab is promising, more denitive studies are needed to fully understand its role in managing recurrent ovarian cancer after PARPinhibitors therapy», they conclude.