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5 treatment settings, 5 with more than one named option. Each section lays out the options the standard of care names, what each is for, the trials behind them with their recorded results, the side effects and cautions on record, and questions to ask. Built from the cancer page's standard-of-care rows; nothing here is advice for your case.
Olaparib for two years (SOLO-1), or olaparib with bevacizumab (PAOLA-1); niraparib as an alternative.
Olaparib was the first PARP inhibitor, and turned an inherited BRCA mutation from a risk factor into a drug target, including after surgery in breast cancer.
Niraparib is a PARP inhibitor approved as maintenance for ovarian cancer regardless of BRCA status, and in prostate cancer with abiraterone.
Pills that block a DNA repair backup, killing cancer cells that already lost their main repair system (BRCA).
Averages across everyone diagnosed, often years ago. A median is the middle of a group: half the people counted lived longer than the figure shown, and some lived far longer. Your stage, subtype, age, fitness and the treatment you receive matter more than the average, and the numbers are improving quickly.
Averages across everyone diagnosed, often years ago. A median is the middle of a group: half the people counted lived longer than the figure shown, and some lived far longer. Your stage, subtype, age, fitness and the treatment you receive matter more than the average, and the numbers are improving quickly.
| Side effect | Any grade | Grade 3+ |
|---|---|---|
| Anaemia · OlympiA adjuvant, n=911 | 24% | 9% |
| Neutropenia · OlympiA adjuvant, n=911 | 16% | 5% |
| Leukopenia · OlympiA adjuvant, n=911 | 17% | 3% |
| Fatigue · OlympiA adjuvant, n=911 | 42% | 1.8% |
Rates from the label or pivotal trial as recorded on the product page; each grade 3+ figure links to its source.
| Side effect | Any grade | Grade 3+ |
|---|---|---|
| Thrombocytopenia · PRIMA | 66% | 38% |
| Anaemia · PRIMA | 65% | 31% |
| Neutropenia · PRIMA | - | 17% |
| Nausea · PRIMA | 62% | - |
Rates from the label or pivotal trial as recorded on the product page; each grade 3+ figure links to its source.
Add these to your appointment list, or take the full question set for this cancer.
Olaparib plus bevacizumab (PAOLA-1) or niraparib (PRIMA) after HRD testing.
Olaparib was the first PARP inhibitor, and turned an inherited BRCA mutation from a risk factor into a drug target, including after surgery in breast cancer.
Bevacizumab is a humanised antibody that soaks up VEGF-A, the signal tumours use to grow new blood vessels. Approved in 2004, it partners chemotherapy in colorectal, ovarian, cervical, lung, kidney and liver cancer and glioblastoma, and adds to trifluridine/tipiracil in late-line bowel cancer; hypertension, protein in the urine and bleeding are its characteristic side effects.
Niraparib is a PARP inhibitor approved as maintenance for ovarian cancer regardless of BRCA status, and in prostate cancer with abiraterone.
Tests that reveal whether a tumour has a broken DNA repair system, which predicts response to PARP inhibitors and platinum.
Averages across everyone diagnosed, often years ago. A median is the middle of a group: half the people counted lived longer than the figure shown, and some lived far longer. Your stage, subtype, age, fitness and the treatment you receive matter more than the average, and the numbers are improving quickly.
PFS HR 0.62 overall, 0.43 HRD-positive; final OS HR 1.01.
| Side effect | Any grade | Grade 3+ |
|---|---|---|
| Anaemia · OlympiA adjuvant, n=911 | 24% | 9% |
| Neutropenia · OlympiA adjuvant, n=911 | 16% | 5% |
| Leukopenia · OlympiA adjuvant, n=911 | 17% | 3% |
| Fatigue · OlympiA adjuvant, n=911 | 42% | 1.8% |
Rates from the label or pivotal trial as recorded on the product page; each grade 3+ figure links to its source.
| Side effect | Any grade | Grade 3+ |
|---|---|---|
| Thrombocytopenia · PRIMA | 66% | 38% |
| Anaemia · PRIMA | 65% | 31% |
| Neutropenia · PRIMA | - | 17% |
| Nausea · PRIMA | 62% | - |
Rates from the label or pivotal trial as recorded on the product page; each grade 3+ figure links to its source.
Add these to your appointment list, or take the full question set for this cancer.
Niraparib (PRIMA, smaller benefit) or bevacizumab; observation is reasonable after discussion.
Niraparib is a PARP inhibitor approved as maintenance for ovarian cancer regardless of BRCA status, and in prostate cancer with abiraterone.
Bevacizumab is a humanised antibody that soaks up VEGF-A, the signal tumours use to grow new blood vessels. Approved in 2004, it partners chemotherapy in colorectal, ovarian, cervical, lung, kidney and liver cancer and glioblastoma, and adds to trifluridine/tipiracil in late-line bowel cancer; hypertension, protein in the urine and bleeding are its characteristic side effects.
PFS HR 0.62 overall, 0.43 HRD-positive; final OS HR 1.01.
GOG-0218 PFS 14.1 vs 10.3 months (HR 0.72); no OS benefit.
| Side effect | Any grade | Grade 3+ |
|---|---|---|
| Thrombocytopenia · PRIMA | 66% | 38% |
| Anaemia · PRIMA | 65% | 31% |
| Neutropenia · PRIMA | - | 17% |
| Nausea · PRIMA | 62% | - |
Rates from the label or pivotal trial as recorded on the product page; each grade 3+ figure links to its source.
Add these to your appointment list, or take the full question set for this cancer.
Secondary cytoreduction in AGO-score-positive patients (DESKTOP III), then carboplatin doublet with pegylated liposomal doxorubicin, gemcitabine or paclitaxel, bevacizumab if not previously given, and PARP inhibitor maintenance if PARP-naive.
Carboplatin is a platinum chemotherapy that crosslinks DNA; it is part of the standard pre-surgery regimen for triple-negative breast cancer.
Doxorubicin wrapped in a fatty bubble so it reaches tumours with less heart damage; a workhorse of relapsed ovarian cancer.
A versatile chemotherapy used in pancreatic, bladder, lung, ovarian, breast and biliary cancers, in nasopharyngeal cancer, and as a bladder instillation.
A microtubule poison discovered in the Pacific yew tree, among the most used chemotherapies in breast, lung, and ovarian cancer.
Bevacizumab is a humanised antibody that soaks up VEGF-A, the signal tumours use to grow new blood vessels. Approved in 2004, it partners chemotherapy in colorectal, ovarian, cervical, lung, kidney and liver cancer and glioblastoma, and adds to trifluridine/tipiracil in late-line bowel cancer; hypertension, protein in the urine and bleeding are its characteristic side effects.
Olaparib was the first PARP inhibitor, and turned an inherited BRCA mutation from a risk factor into a drug target, including after surgery in breast cancer.
Niraparib is a PARP inhibitor approved as maintenance for ovarian cancer regardless of BRCA status, and in prostate cancer with abiraterone.
A PARP inhibitor for BRCA-mutated ovarian and prostate cancer whose original maker went bankrupt; still available, with a narrowed label.
OS 53.7 vs 46.0 months (HR 0.75).
| Side effect | Any grade | Grade 3+ |
|---|---|---|
| Anaemia · OlympiA adjuvant, n=911 | 24% | 9% |
| Neutropenia · OlympiA adjuvant, n=911 | 16% | 5% |
| Leukopenia · OlympiA adjuvant, n=911 | 17% | 3% |
| Fatigue · OlympiA adjuvant, n=911 | 42% | 1.8% |
Rates from the label or pivotal trial as recorded on the product page; each grade 3+ figure links to its source.
| Side effect | Any grade | Grade 3+ |
|---|---|---|
| Thrombocytopenia · PRIMA | 66% | 38% |
| Anaemia · PRIMA | 65% | 31% |
| Neutropenia · PRIMA | - | 17% |
| Nausea · PRIMA | 62% | - |
Rates from the label or pivotal trial as recorded on the product page; each grade 3+ figure links to its source.
Add these to your appointment list, or take the full question set for this cancer.
Platinum doublet; PARP rechallenge has limited benefit; trials of ATR, WEE1 and next-generation PARP1-selective inhibitors.
Carboplatin is a platinum chemotherapy that crosslinks DNA; it is part of the standard pre-surgery regimen for triple-negative breast cancer.
Saruparib is an experimental small-molecule drug from AstraZeneca in phase 3 trials for prostate cancer, ovarian cancer and non-small-cell lung cancer, aimed at PARP.
PFS 20.2 vs 9.2 months (HR 0.52).
Add these to your appointment list, or take the full question set for this cancer.