TAMPA (Saturday, March 25, 2023) – Administering PARP inhibitor (PARPi) olaparib prior to surgical intervention and chemotherapy in ovarian cancer patients with a germline mutation – a new approach – is feasible and resulted in favorable surgical options, managable adverse events, and positive health outcomes, according to results from the Neoadjuvant Olaparib Window (NOW) Trial presented today by Shannon N. Westin, MD, MPH et al. at the Society of Gynecologic Oncology (SGO) 2023 Annual Meeting on Women’s Cancer.
Results from this study showed that olaparib given in the neoadjuvant (NA) setting was feasible, with 100% of trial participants able to receive the planned two cycles. Of 93% participants able to to undergo subsequent surgery, all achieved optimal tumor reduction.
Among patients treated first with two cycles of NA olaparib, followed by surgery and adjuvant CT, 85% had no evidence of disease at the completion of all therapies.
Adverse events during olaparib treatment were as expected with abdominal pain, constipation, anemia, nausea, and pain observed most commonly. The only severe adverse event reported was G3 anemia in three patients.
“Patients are interested in receiving therapies specifically targeting their tumor,” Westin shares. “There was great excitement among patients for the opportunity to not receive chemotherapy.”
The NOW Trial (NCT03943173) was a single arm, open label pilot study for advanced stage, high grade epithelial ovarian, peritoneal, or fallopian tube carcinoma. All patients had germline mutation in BRCA1, BRCA2, RAD51C or PALB2. Fifteen total patients were treated, with median age of 56 years. Forty percent had stage four disease.
Historically, PARPi usage has followed cytotoxic chemotherapy as a maintenance medication, often taken long-term amongst patients with ovarian cancer.
These new findings help justify further research studies to determine if PARPi can be given in lieu of chemotherapy in the NA setting – a new usage of the medication.
“This study provides a potential template for how we might vet targeted therapies earlier in the treatment continuum,” Westin said. “As drug options increase, it is encouraging to see opportunities for patients to get testing at diagnosis and receive targeted therapy in lieu of or in addition to chemotherapy.”
About SGO
The Society of Gynecologic Oncology (SGO) is the premier medical specialty society for health care professionals trained in the comprehensive management of gynecologic cancers. As a 501(c)(6) organization, SGO contributes to the advancement of gyn cancer care by encouraging research, providing education, raising standards of practice, advocating for patients and members and collaborating with other domestic and international organizations. Learn more at www.sgo.org.
