ESMO updates ovarian cancer guidelines

  • ESMO
  • 1 Apr 2020

  • curated by Deepa Koli
  • Univadis Clinical Summaries
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Takeaway

  • The European Society for Medical Oncology (ESMO) has issued an update to its 2013 guidelines for the treatment of patients with relapsed epithelial ovarian cancer.

Key recommendations

  • Maintenance therapy with PARP (poly [ADP-ribose] polymerase) inhibitors olaparib, niraparib, or rucaparib after a response to platinum-based therapy was approved irrespective of BRCA status.
    • PFS benefit was seen with all 3 therapies in BRCA-mutated (germline [gBRCA] or somatic [sBRCA]) and also in BRCA wild-type tumors.
    • Niraparib:
      • Patients with gBRCA mutation:
        • Median PFS, 21.0 vs 5.5 months.
        • HR, 0.27 (95% CI, 0.17-0.41).
      • Non-gBRCA patients (including sBRCA):
        • Median PFS, 9.3 vs 3.9 months.
        • HR, 0.45 (95% CI, 0.34-0.61).
    • Rucaparib:
      • Overall:
        • Median PFS 10.8 vs 5.4 months.
        • HR, 0.36 (95% CI, 0.30-0.45).
      • BRCA-positive patients:
        • Median PFS, 16.0 vs 5.4 months.
        • HR, 0.23 (95% CI, 0.16-0.34).
    • Olaparib:
      • BRCA-positive patients:
        • Median PFS 19.1 vs 5.5 months.
        • HR, 0.30 (95% CI, 0.22-0.41).
      • Non-BRCA-mutated tumors:
        • Median PFS, 7.4 vs 5.5 months.
        • HR, 0.54 (95% CI, 0.34-0.85).
  • Rucaparib monotherapy was also approved for patients with BRCA mutation who have received ≥2 lines of therapy and cannot receive platinum-based treatment.
    • Response rate with rucaparib was 53.8% (complete response, 8.5%; partial response, 45.3%).
    • Median duration of response was 9.2 (95% CI, 6.6-11.6) months.