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PARP Inhibitors in the management of ovarian cancer: ASCO guideline rapid recommendation update

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Last updated:22nd Sep 2022
Availability: Free full text
Status: Current
Poly(ADP-Ribose) Polymerase Inhibitors in the Management of Ovarian Cancer: ASCO Guideline Rapid Recommendation Update - American Society of Clinical Oncology (ASCO)


ASCO Rapid Recommendations Updates highlight revisions to select ASCO guideline recommendations as a response to the emergence of new and practice-changing data. The rapid updates are supported by an evidence review and follow the guideline development processes outlined in the ASCO Guideline Methodology Manual. The goal of these articles is to disseminate updated recommendations, in a timely manner, to better inform health practitioners and the public on the best available cancer care options.

Background: In 2020, ASCO published a guideline on poly(ADP-ribose) polymerase inhibitor (PARPi) therapy in the management of ovarian cancer.1 In June 2022, the ATHENA-MONO2 phase III multinational, double-blind, randomized controlled trial (RCT) evaluating rucaparib monotherapy reported on the efficacy of rucaparib maintenance therapy compared with placebo in patients with stage III-IV epithelial ovarian cancer (EOC) who are in complete or partial response to first-line platinum-based chemotherapy. A significant improvement in progression-free survival (PFS) constituted a strong signal for an update of the 2020 ASCO guideline recommendation for first-line maintenance therapy. Furthermore, reports of detrimental overall survival (OS) from the ARIEL4 trial3 (rucaparib), SOLO3 trial (olaparib),4 and ENGOT-OV16/NOVA trial5 (niraparib) constituted safety signals for recommendation updates for treatment in recurrent platinum-sensitive EOC (BRCA mutation or homologous recombination deficiency [HRD] positive status) and in unselected patient population second-line maintenance treatment, respectively.


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