Maintenance olaparib with bevacizumab improves progression-free Survival in patients with newly diagnosed ovarian cancer

2019-12-30

Currently, olaparib and bevacizumab are both approved by the US FDA as first-line maintenance therapy of ovarian cancer. In the phase 3 PAOLA study, olaparib plus bevacizumab was used as maintenance treatment in ovarian cancer patients who had response after first-line platinum-taxane chemotherapy plus bevacizumab. In the intent-to-treat population, the median PFS was 22.1 months for the combination group and was 16.6 months for the control group (placebo plus bevacizumab) (HR 0.59, 95% CI 0.49-0.72). In patients with BRCA mutation, the addition of olaparib improved the median PFS from 21.7 to 37.2 months (HR 0.31, 95% CI 0.20-0.47). Moreover, BRCA wild-type patients were classified into homologous recombination repair deficiency (HRD) and HRD-negative groups. The combination of olaparib and bevacizumab significantly improved the median PFS when compared with the control group in the HRD-positive population (28.1 vs. 16.6 months, HR 0.43, 95CI 0.28-0.66). By contrast, the median PFS was similar for both groups in HRD-negative patients (16.9 vs. 16.6 months, HR 0.92, 95% CI 0.72-1.17). Based on these results, the addition of olaparib to bevacizumab maintenance therapy can prolong the PFS in ovarian cancer patients who have a BRCA mutation or HRD.

N Engl J Med. 2019 Dec 19;381(25):2416-2428.

https://www.nejm.org/doi/full/10.1056/NEJMoa1911361?url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org&rfr_dat=cr_pub%3Dpubmed

Annals of Oncology (2019) 30 (suppl_5): v851-v934.

https://oncologypro.esmo.org/Meeting-Resources/ESMO-2019-Congress/Phase-III-PAOLA-1-ENGOT-ov25-trial-Olaparib-plus-bevacizumab-bev-as-maintenance-therapy-in-patients-pts-with-newly-diagnosed-advanced-ovarian-cancer-OC-treated-with-platinum-based-chemotherapy-PCh-plus-bev