Niraparib治療卵巢癌的檢視

The role of niraparib in the treatment of women with ovarian cancer

Niraparib乃一種口服PARP1/2抑制劑，對復發的高度分化和鉑化學藥物靈敏的上皮性卵巢癌、輸卵管癌和原發性癌，已漸成為治療的首選藥物，無論有、無BRCA突變或同源重組的缺陷皆有助益。最近研究證明，niraparib做維持治療能延長無症狀生存時間，且不會嚴重影響生活品質，但對延長存活時間尚無確切資料。Niraparib的有效性可能因其具有高度生物利用性、易穿透細胞膜、親脂性和能在腫瘤細胞中大量存在。現階段的研究，在於合併抗血管增生和免疫檢測點抑制劑的使用，以增強抗腫瘤能力。

Niraparib, an oral PARP (poly ADP-ribose polymerase)1/2 inhibitor, have transformed the treatment landscape in front-line and recurrent high-grade epithelial ovarian, fallopian tube and primary peritoneal cancer who are in a complete response or partial response in platinum-base chemotherapy, regardless of the presence or absence of BRCA mutations or HRD (homologous recombination deficiency) status. Several recent studies have shown progression-free survival advantage with niraparib for maintance therapy, with no major adverse changes in the quality of life, however, overall survival data remain immature to date. The effect of niraparib is though to be due to the high exposure of tumors to the drug as a result of its high bioavailabity, membrane permeability, lipophilicity, and large volume of distribution. Comtemporay studies are looking into potentially synergistic combination strategies with anti-angiogenics and immune checkpoint inhibitors, among others.