Abstract:
The majority of patients with advanced, high-grade epithelial-tubo ovarian cancer (EOC) respond well to initial treatment with platinum-based chemotherapy; however, up to 80% of patients will experience a recurrence. Poly(ADP-ribose) Polymerase (PARP) inhibitors have been established as a standard of care maintenance therapy to prolong remission and prevent relapse following a response to first-line platinum-chemotherapy. Olaparib and niraparib are the PARP inhibitors currently approved for use in the first-line maintenance setting in Canada. Selection of maintenance therapy requires consideration of patient and tumour factors, presence of germline and somatic mutations, expected drug toxicity profile, and treatment access. This paper discusses the current clinical evidence for first-line PARP inhibitor maintenance therapy in patients with advanced, high-grade EOC and presents consensus statements and a treatment algorithm to aid Canadian oncologists on the selection and use of PARP inhibitors within the Canadian EOC treatment landscape.
摘要:
大多数晚期患者,高级别上皮-肿瘤卵巢癌(EOC)对铂类化疗的初始治疗反应良好;然而,高达80%的患者将经历复发。聚(ADP-核糖)聚合酶(PARP)抑制剂已被确立为护理维持治疗的标准,以延长缓解时间并防止对一线铂化疗产生反应后的复发。Olaparib和niraparib是目前在加拿大批准用于一线维护的PARP抑制剂。选择维持治疗需要考虑患者和肿瘤因素,种系和体细胞突变的存在,预期的药物毒性概况,和治疗准入。本文讨论了PARP抑制剂一线维持治疗晚期患者的临床证据,高级EOC,并提供共识声明和治疗算法,以帮助加拿大肿瘤学家在加拿大EOC治疗环境中选择和使用PARP抑制剂。