PARP Inhibitors Have ‘Completely Changed Clinical Practice’ in Ovarian Cancer
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/ Updated August 4th, 2023

PARP Inhibitors Have ‘Completely Changed Clinical Practice’ in Ovarian Cancer

Medically Reviewed: Dr. Elisabeth Diver Written by Dr. Helen Eshed
Texas Oncology
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How Clinical Trials Have Made PARP Inhibitors a 'Go-To' Treatment for Ovarian Cancer

  • ASCO guidelines recommend PARP inhibitors for women with newly diagnosed stage III or IV epithelial ovarian cancer who have improved with chemotherapy.
  • PARP inhibitors work by preventing damaged cancer cells from repairing themselves.
  • Clinical trials showed that PARP inhibitors could be extremely effective at preventing ovarian cancer recurrence, especially among women whose cancers have BRCA gene mutations.
Among women diagnosed with ovarian cancer, “the vast majority of people will receive a PARP inhibitor at some point along the way in their treatment,” says Dr. Helen Eshed, a gynecologic oncologist at Texas Oncology in Austin.

The widespread use of PARP inhibitors is thanks to the positive results that came out of a number of key clinical trials, several of which actually took place right in Austin. The clinical trials have shown that PARP inhibitors can offer a significant survival benefit for women with ovarian cancer. Accordingly, these trials have led to U.S. Food and Drug Administration (FDA) approval.

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The American Society of Clinical Oncology (ASCO) released guidelines recommending PARP inhibitors be offered to women, with or without genetic mutations, who are newly diagnosed with stage III or IV ovarian cancer and have improved with chemotherapy. The PARP inhibitor Zejula (niraparib) has been approved by the FDA for all women with newly-diagnosed ovarian cancer. The drug is used after successful treatment with a platinum-based chemotherapy, the mainstay chemotherapy for ovarian cancer.

The PARP inhibitor Lynparza (olaparib) is approved for women newly diagnosed with ovarian cancer and with a germline or somatic mutation in BRCA1/2. Lynparza is also approved in combination with Avastin (bevacizumab) for women with HRD.  The label homologous recombination deficient (HRD) indicates a tumor which has one of many possible errors in the double stranded DNA repair process of homologous recombination. Avastin is a blood vessel growth inhibitor, which works by starving the tumor of vital nutrients needed to grow.

PARP inhibitors, Dr. Eshed says, have “completely changed clinical practice.”

So what, exactly, is a PARP inhibitor and how does it benefit women with ovarian cancer?

These drugs — all of which are taken orally, meaning by mouth — work by preventing cells from repairing DNA that has been damaged during the course of treatment. This makes the drugs a particularly good option for preventing recurrence; after receiving chemotherapy, which damages cancerous cell DNA, a PARP inhibitor drug can keep the cells from recovering and spreading once more.

Although more recent clinical trials have shown that PARP inhibitors can benefit all ovarian cancers regardless of their DNA mutation status, Dr. Eshed does point out that the most impressive benefit has been seen in women whose cancers harbor BRCA 1 or BRCA 2 gene mutations.

“After undergoing surgical resection of cancer and then platinum-based chemotherapy, all patients with a BRCA-1 or 2 mutations receive PARP inhibitors in maintenance because the outcomes have been so remarkably impressive,” says Dr. Eshed.

Learn more about SurvivorNet's rigorous medical review process.

Dr. Helen Eshed is a gynecologic oncologist at Texas Oncology in Austin. Read More

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