important menopause information
Living longer with ovarian cancer: a drug that prolongs life
Ovarian cancer is the deadliest of all of the gynecologist cancers. The treatment of ovarian cancer is at first surgery to remove as much tumor as possible, followed by the standard chemotherapy of carboplatinum and paclitaxil. It is not uncommon for the cancer to return within two years, requiring the use of additional chemotherapy.
Researches have added other drugs in combination to extend disease-feee survival (DFS).
In 2017, bevacizumab (Avastin) was approved for advanced ovarian cancer. It extended DFS 4 months, but not overall survival.
A class of drug called PARP inhibitors has been studied. PARP is an enzyme that repairs DNA damage in cells. Inhibitors affect the DNA repair, and also work in BRCA mutation carriers.
Three PARP inhibitors have been approved in the US. They are used as maintenance therapy in women with recurrent ovarian cancer.
A study was done using olaparib (Lynparza) in women who were BRCA mutation carriers, diagnosed with Stage 3 ovarian cancer of the ovary, fallopian tube, or peritoneum. Stage 3 ovarian cancer means that the cancer has spread beyond the ovaries to the abdominal cavity. These patients were debulked surgically, then given platinum based chemotherapy which was at least partially effective. The women in the study were given either the olaparib vs. placebo.
They were followed for 41 months, at that time, 60% who received the drug were disease-free, vs. only 27% in the placebo group. Progression-free survival was 36 months longer in the study group.
Side effetcs occurred in 21% of patients compared to 12% in the placebo group. Most of these side effects were anemia, although !% of patients developed acute myeloid leukemia.
Most drugs that treat cancer are measured in months of disease-free survival. The fact that olaparib extended survival by 3 years is a tremendous advancement.
Marilyn C. Jerome, MD
Foxhall OB-Gyn Associates
PARP inhibitors extend survival in ovarian cancer, especially for women with a BRCA mutation.
OBG Management, Volume 31, No. 3, March 2019