ASCO Updates Living Guideline on PARP Inhibitors in Ovarian Cancer

ASCO's updated living guideline reviews 79 publications, including 13 HRD assays and 31 pivotal trials, to guide PARP inhibitor (PARPi) use in epithelial ovarian cancer. The guideline reports that frontline PARPi maintenance showed progression-free survival benefits, while later-line and recurrent maintenance trials showed potential overall survival disadvantages. Recommendations include genetic and HRD testing for newly diagnosed advanced disease, prioritizing PARPi maintenance at first remission for patients with BRCA mutations or HRD-positive disease, restricting PARPi use in recurrent disease to PARPi-naive BRCA-mutated patients, avoiding PARPi monotherapy or combinations outside trials, and monitoring for adverse events such as myelodysplastic syndrome, acute myeloid leukemia, and pulmonary complications.

Most relevant for: Patients with newly diagnosed advanced or recurrent epithelial ovarian cancer being considered for PARP inhibitor maintenance therapy.

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