Olaparib for the treatment of epithelial ovarian cancer

ABSTRACT

Introduction: Despite recent advances in the management of epithelial ovarian cancer, overall survival rates remain poor, and there is a pressing need to develop novel therapeutic agents and maintenance strategies to improve outcomes for women with this disease. Olaparib, a potent oral poly(ADP-ribose) polymerase (PARP) inhibitor, has demonstrated antitumor activity in women with ovarian cancer, associated with homologous recombination deficiency.

Areas covered: This review outlines the rationale for PARP inhibitor therapy in ovarian cancer and summarizes the efficacy and tolerability data for olaparib to date. Ongoing phase III clinical trials of olaparib in ovarian cancer will be discussed.

Expert opinion: There are a number of issues regarding the optimal use of olaparib in ovarian cancer, including the identification of a homologous recombination deficiency signature to predict treatment response, establishment of the optimal treatment setting (maintenance or relapsed disease), and evaluation of cost-effectiveness. Finally, the long term consequences of PARP inhibitors, including the risk of myelodysplasia and acute myeloid leukemia need to be quantified in ongoing large phase III clinical trials.

KEYWORDS:

• BRCA
• homologous recombination
• olaparib
• ovarian cancer
• PARP inhibitor

Acknowledgements

The authors would like to thank the Royal Marsden and Institute of Cancer Research National Institute for Health Research (NIHR), Biomedical Research Centre for Cancer (BRC) and the Gynaecological Cancers Fund.

Declaration of interest

S Banerjee has participated in advisory boards for Astrazeneca and Clovis with no personal financial renumeration. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.