Rubraca with bevacizumab for maintenace for ovarian cancer – pro
On April 6, 2018, the Food and Drug Administration approved rucaparib (Rubraca®, Clovis Oncology Inc.), a poly ADP-ribose polymerase (PARP) inhibitor, for the maintenance treatment of recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer who are in a complete or partial response to platinum-based chemotherapy.
Approval was based on ARIEL3 (NCT01968213), a randomized, double-blind, placebo-controlled trial in 561 patients with recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer who had been treated with at least two prior treatments of platinum-based chemotherapy and were in complete or partial response to the most recent platinum-based chemotherapy. Patients were randomized (2:1) to rucaparib 600 mg orally twice daily (n=372) or placebo (n=189) and were treated until disease progression or unacceptable toxicity.
The addition of olaparib to bevacizumab maintenance therapy after first-line platinum-based chemotherapy and bevacizumab significantly improved PFS among women with advanced ovarian cancer, according to results of the randomized phase 3 PAOLA-1/ENGOT-ov25 study presented at European Society for Medical Oncology Congress.
Similar results are being accrued with other PARP inhibitiors with bevacizumab, such as .PAOLA-1/ENGOT-ov25 with olaparib. Howeer, I did not find a study with bevacizumab and Rubraca, and there is sitll an nogoing trial of this combination, Rucaparib MAintenance After Bevacizumab Maintenance Following Carboplatin Based First Line Chemotherapy in Ovarian Cancer Patients, NCT04227522.
Coleman RL, Oza AM, Lorusso D, et al. Rucaparib maintenance treatment for recurrent ovarian carcinoma after response to platinum therapy (ARIEL3): a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet. 2017;390(10106):1949-1961.
Hardesty MM, Fleming EL, Keeton E, et al. Phase II OVARIO study of niraparib + bevacizumab therapy in advanced ovarian cancer following front-line platinum-based chemotherapy with bevacizumab. Data made available as part of the virtual platform for the SGO 2020 Annual Meeting. Abstract 4. bit.ly/2RmcX8P.
PAOLA-1/ENGOT-ov25, Annals of Oncology (2019) 30 (suppl_5): v851-v934. 10.1093/annonc/mdz394
Mirza MR, Avall-Lundqvist E, Birrer MJ, et al. Combination of niraparib and bevacizumab versus niraparib alone as treatment of recurrent platinum-sensitive ovarian cancer: a randomized controlled chemotherapy-free studyNSGO-AVANOVA2/ENGOT-OV24.J Clin Oncol. 2019;37(suppl 15; abstr 5505). doi: 10.1200/JCO.2019.37.15_suppl.5505
Mirza MR, Lundqvist E Å, Birrer M, et al. Niraparib plus bevacizumab versus niraparib alone for platinum-sensitive recurrent ovarian cancer (NSGO-AVANOVA2/ENGOT-ov24): a randomised, phase 2, superiority trial.Lancet Oncol.2019;20(10):1409-1419. doi: 10.1016/S1470-2045(19)30515-7
NCCN Ovarian Cancer OV-6 2020