Dr. Chase on Niraparib as Frontline Maintenance Therapy in Ovarian Cancer

Dana Chase, MD, FACOG, assistant professor at the University of Arizona College of Medicine Phoenix and Creighton University at St. Joseph’s Hospital and Medical Center, Arizona Oncology, The US Oncology Network, discusses the use of niraparib (Zejula) as frontline maintenance therapy in ovarian cancer.

The phase III PRIMA trial is one of the first trials to demonstrate the efficacy of PARP inhibitors, specifically niraparib, in frontline maintenance therapy, says Chase. In December 2018, olaparib (Lynparza) was approved by the FDA for the maintenance treatment of adult patients with deleterious or suspected deleterious germline or somatic BRCA-mutated advanced epithelial ovarian, fallopian tube, or primary peritoneal cancer who are in complete or partial response to first-line platinum-based chemotherapy. However, in the PRIMA trial, investigators administered niraparib to all comers, which is new and unique, according to Chase.

Previously, the standard of care for patients with ovarian cancer who did not have a BRCAmutation was chemotherapy followed by surveillance, says Chase. Other patients received bevacizumab (Avastin) with chemotherapy and continued bevacizumab as frontline maintenance. Until PRIMA, there was no access to use PARP inhibitor therapy in the all-comer patient population, concludes Chase.