Matthew Anderson, MD, PhD, discusses how the results with niraparib for patients with advanced ovarian cancer impacts the use of somatic profiling in this patient population.
Matthew L. Anderson, MD, PhD, professor and director of the College of Medicine Obstetrics & Gynecology at the University of South Florida Morsani College of Medicine, as well as the associate director for shared resources at the Tampa General Hospital Cancer Institute, discusses the use of niraparib (Zejula) for patients with ovarian cancer who have somatic mutations and homologous recombination deficiencies (HRD) in their disease.
The PARP inhibitor niraparib is approved for adult patients with advanced ovarian cancer who had a complete or partial response to first-line platinum-based chemotherapy. This approval was based on efficacy data from the phase 3 PRIMA (NCT02655016) study that showed a statistically significant improvement in progression-free survival (PFS) for patients with HRD.
Median PFS in this population was 21.9 months (range, 19.3–not estimable) for those receiving niraparib compared with a median of 10.4 months (range, 8.1-12.1) for patients receiving placebo (HR, 0.43; 95% CI, 0.31-0.59; P < .0001).
Patients who are positive for HRD are categorized by the presence of a somatic or germline mutation of DNA repair genes such as BRCA1/2, PALB2, RAD51C, and ATM. Niraparib is also approved for patients with advanced ovarian cancer regardless of their HRD status, and improved patients PFS regardless of that status at a median of 13.8 months (range, 11.5-14.9) vs 8.2 months (range, 7.3-8.5) with placebo (HR, 0.62; 95% CI, 0.50-0.76; P < .0001).
According to Anderson these data make the case for somatic tumor profiling in every patient with ovarian cancer to create a better targeted treatment plan for patients.
0:08 | I think there's great data to show that the use of niraparib is a very powerful option for patients, particularly for patients with ovarian cancer with somatic deficiencies and HRD for first-line maintenance suppression of disease recurrences. I think that really at this point…somatic tumor profiling should be considered for every single patient with ovarian cancer, so that the use of niraparib can be considered as the care of these patients continues through the completion of their frontline chemotherapy.
0:52 | This really should be an option that we're considering for all of our patients with HRD ovarian cancers at the time they finish carboplatin and platinum-based chemotherapy. This gives them the opportunity to very dramatically reduce the chances that, that cancer is going to recur over the subsequent 2 years.