Niraparib: A Review in First-Line Maintenance Therapy in Advanced Ovarian Cancer.
Arnold LeePublished in: Targeted oncology (2021)
Niraparib (Zejula™) is a PARP inhibitor which is approved for maintenance therapy in adults with advanced ovarian cancer in complete or partial response to platinum-based chemotherapy. In a placebo-controlled phase III trial in patients with newly diagnosed advanced ovarian cancer, niraparib significantly extended progression free survival in two predefined populations, namely a patient population with altered homologous-recombination DNA repair pathways [i.e. homologous-recombination deficiency positive (HRd)] and the overall trial population. A prespecified exploratory subgroup analysis indicated that niraparib was also efficacious in patients who were homologous recombination deficiency negative or homologous recombination proficient (HRp). Niraparib has a manageable tolerability profile with myelosuppression as the main safety concern. Haematological reactions were managed with monitoring and dose reduction or interruption. A weight- and platelet count-based individualised dosage regimen introduced during the trial (and subsequently approved) appeared to improve haematological tolerability. Niraparib is a useful option for first-line maintenance therapy for advanced ovarian cancer in adults who responded to platinum-based chemotherapy, regardless of homologous-recombination deficiency status and is a promising option for HRp patients, for whom maintenance treatment options are limited.
Keyphrases
- dna repair
- phase iii
- open label
- placebo controlled
- dna damage
- double blind
- newly diagnosed
- phase ii
- clinical trial
- dna damage response
- study protocol
- free survival
- phase ii study
- replacement therapy
- locally advanced
- end stage renal disease
- randomized controlled trial
- squamous cell carcinoma
- stem cells
- weight loss
- bone marrow
- body mass index
- mesenchymal stem cells
- peripheral blood
- case report
- drug administration