Maintenance niraparib therapy for patients with relapsed platinum sensitive ovarian cancer: experience at a south coast network

Ovarian cancer continues to be a challenge to treatment teams with approximately 20 new diagnoses in the UK each day. Survival at 10 years post-diagnosis is now improving and currently sits at 35% (Cancer Research UK, 2021). Ovarian cancer is a complex disease where traditional treatment pathways include surgery where possible, and platinum-based chemotherapy. However, most recently with an understanding of genetics and the molecular basis of cancer, some targeted therapies have emerged, including anti-angiogenesis agents such as bevacizumab and now poly (ADP-ribose) polymerase inhibitor (PARP) inhibitors such as niraparib (Mittica et al, 2018).

The utility of chemotherapy treatment approaches for ovarian cancer were primarily based on the number of disease-free months between regimens and judgements based on sensitivity to platinum compounds, whereas now, it is recommended platinum-based chemotherapy should be offered to all patients with a reasonable chance of responding to this therapy (Baert et al, 2021). Therefore, the disease-free interval is only one of the factors now considered as bevacizumab increases the response to chemotherapy irrespective of the cytotoxic regimen and can be valuable in patients with an urgent need for symptom relief (such as pleural effusion, ascites). PARP inhibitors are the newest area of focus and are a welcome addition to the treatment pathway following platinum therapy.