PARP inhibitor has showed limited activity as monotherapy in platinum-resistant ovarian cancer patients. The objective response rate (ORR) is 25%-30% among BRCA-mutated platinum-resistant patients. However, in BRCA wild-type platinum-resistant patients, the objective response rate is only 5%. The phase I/II TOPACIO/KEYNOTE-162 study aims to find whether niraparib plus pembrolizumab would have better efficacy in difficult-to treat ovarian cancer patients. Findings showed that in the 60 evaluable patients, the overall response rate was 25% and the duration of response was 9.3 months. Furthermore, ORR was 23% and 25% in the BRCA wild-type and homologous recombination deficiency(HRD)-negative population, respectively. This study demonstrates that the combination of pembrolizumab and niraparib in BRCA wild-type and HRD-negative could lead to similar ORR results to PARP inhibitor monotherapy in the BRCA-mutated patients.
Konstantinopoulos PA, Waggoner SE, Vidal GA, et al. J Clin Oncol. 2018;36 (suppl; abstr 106).