Olaparib用在卵巢癌維持治療的檢視

The role of olaparib in maintenance therapy of ovarian cancer

PARP抑制劑能阻止DNA修復，致使腫瘤細胞凋亡。Olaparib是最常用的PARP抑制劑，對鉑治療後復發性卵巢癌，特別是有BRCA突變者，維持治療可延長無惡性生存時間。最近研究更將olaparib作為第一線用藥。在一篇報告為SOLO-1，對有BRCA突變卵巢癌患者於化學完全和部分有效治療後，予每天口服olaparib 300 mg做維持治療，結果無惡化生存時間較安慰組延長約3年。美國食品和藥物管理局亦通過，olaparib可用作以鉑為主化學治療有效的復發性卵巢癌、輸卵管和原發性腹膜癌的維持治療。

Poly (ADP-ribose) polymerase (PARP) inhibitors are a class of drugs that target the ability of a cell to rapair DNA. Most of the published data of PARP inhibitors are with olaparib. Maintanance therapy with olaparib, a poly ADP ribose polymerase inhibitor given post-platinum therapy for recurrent ovarian cancer, has led to a prolongation in progression-free survival, particularly, in patient with a BRCA mutation. Consequently, there has been increasing investigation in using PARP inhibitors as treatment component of front-line therapy. Investigations are ongoing or planned incorporating PARP inhibitors as monotherapy or in novel combinations as maintenance following front-line induction chemotherapy. The first study to report on this is SOLO-1, which randomized patients with germline BRCA mutations of ovarian cancer to receive olaparib 300 mg tablets twice daily or placebo for up to 2 years following complete or partial response to front-line therapy. This study reported an unprecedented improvement in median progression-free survival (PFS) of 13.8 months in the placebo arm and olaparib appears to be approximately 3 years longer than the placebo arm. In 2017, the Food and Drug Administration approved that the maintenance treatment of adult patients with recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer, who are in a complete or partial reesponse to platinum-based chemotherapy.