{"entity":{"id":"parp-plus-bevacizumab","kind":"pairing","name":"PARP inhibitor + bevacizumab maintenance (HRD-positive)","aka":[],"tldr":"In tumours with faulty DNA repair, adding olaparib to bevacizumab maintenance roughly doubled progression-free time and improved survival.","summary":"In newly diagnosed advanced ovarian cancer with homologous recombination deficiency, adding the PARP inhibitor olaparib to bevacizumab maintenance is a combination pairing that markedly prolonged progression-free time and improved overall survival in the phase 3 PAOLA-1 / ENGOT-ov25 trial, with no benefit seen in HRD-negative tumours. The mechanistic rationale is that anti-angiogenic hypoxia may push tumour cells into HRD-like states and greater dependence on PARP, and the two agents have non-overlapping toxicity. The combination was approved in 2020. Because the benefit was confined to the HRD-positive subgroup, the pairing made HRD testing a routine first-line decision in ovarian cancer.","asOf":"2026-09-07","links":[{"label":"ClinicalTrials.gov NCT02477644: PAOLA-1 / ENGOT-ov25","url":"https://clinicaltrials.gov/study/NCT02477644"}],"tags":[],"related":[],"cancers":["ovarian"],"sections":[],"technologies":[],"targets":["parp","vegf"],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":["hrd"],"trials":["paola-1"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"a":"olaparib","b":"bevacizumab","rationale":"Anti-angiogenic hypoxia may increase HRD-like states and PARP dependence; the two agents have non-overlapping toxicity.","evidence":"Phase 3 with OS benefit in HRD-positive subgroup.","pairingType":"combination"},"route":"/pairings/parp-plus-bevacizumab/","neighbours":{"cancer":[{"id":"ovarian","kind":"cancer","name":"Ovarian cancer","route":"/cancers/ovarian/"},{"id":"platinum-sensitive-ovarian-cancer","kind":"cancer","name":"Platinum-sensitive ovarian cancer","route":"/cancers/platinum-sensitive-ovarian-cancer/"}],"target":[{"id":"parp","kind":"target","name":"PARP","route":"/targets/parp/"},{"id":"vegf","kind":"target","name":"VEGF / VEGFR","route":"/targets/vegf/"}],"term":[{"id":"hrd","kind":"term","name":"Homologous recombination deficiency (HRD)","route":"/terms/hrd/"}],"trial":[{"id":"paola-1","kind":"trial","name":"PAOLA-1 / ENGOT-ov25","route":"/trials/paola-1/"}],"drug":[{"id":"bevacizumab","kind":"drug","name":"Bevacizumab","route":"/drugs/bevacizumab/"},{"id":"olaparib","kind":"drug","name":"Olaparib","route":"/drugs/olaparib/"}]}}