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SGO 2019: Niraparib Maintenance and Quality of Life in Recurrent Ovarian Cancer

By: Melissa E. Fryman, MS
Posted: Tuesday, March 26, 2019

Niraparib maintenance can maintain remission and prolong the time without symptoms or toxicities (TWiST) experienced by patients with platinum-sensitive recurrent ovarian cancer. Ursula A. Matulonis, MD, of the Dana-Farber Cancer Institute, Boston, and colleagues previously found that maintenance treatment with the PARP inhibitor niraparib in this patient population could improve progression-free survival without significantly decreasing quality of life, compared with placebo. Here, they quantified the mean duration of toxicity and symptom-free benefit. The TWiST analysis results of the ENGOT24-OV16/NOVA trial were presented during the Plenary Session at the 2019 Society of Gynecologic Oncology (SGO) Annual Meeting on Women’s Cancer in Honolulu (Abstract 1).

In this phase III, double-blind trial, 553 women with platinum-sensitive recurrent ovarian cancer were randomly assigned to receive niraparib or placebo. Patients had either germline BRCA mutations or high-grade serous cancer and were followed until disease progression. TWiST was estimated as the difference between progression-free-survival and mean toxicity time, which was defined as the number of days with symptomatic adverse events (classified as grade 2 or greater fatigue, nausea, and vomiting). The mean TWiST benefit for niraparib-treated patients, compared with placebo, was 2.95 years (for those with germline BRCA mutations) and 1.34 years (for those with high-grade serous cancer).

“It’s really important to demonstrate that, if we’re adding a maintenance therapy, we’re not significantly altering women’s quality of life,” emphasized Dr. Matulonis in an SGO press release. “They now have the option to prolong their progression-free survival with a PARP inhibitor.” The ultimate goal, she said, should be to avoid unacceptable toxicities while keeping cancer in remission.

Disclosure: The study authors’ disclosure information may be found at sgo.confex.com.



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