First-line PARP inhibitor maintenance treatment in ovarian carcinoma for older adult women: a review of the current literature

• Published in: Clinical & translational oncology 2025-02, Vol.27 (2), p.417-424
• Main Authors: Masvidal Hernandez, Maria, Cros Costa, Sara, Salvador Coloma, Carmen, Quilez Cutillas, Alicia, Barretina-Ginesta, Maria-Pilar, Cotes Sanchís, Almudena
• Format: Article
• Language: English
• Subjects: Age Factors; Aged; Clinical Trials, Phase III as Topic; Female; Humans; Maintenance Chemotherapy - methods; Medicine; Medicine & Public Health; Oncology; Ovarian Neoplasms - drug therapy; Poly(ADP-ribose) Polymerase Inhibitors - therapeutic use; Quality of Life; Randomized Controlled Trials as Topic; Review Article
• ISSN: 1699-3055; 1699-3055
• DOI: 10.1007/s12094-024-03609-y

Ovarian cancer (OC) is the leading cause of death in women with gynecological cancers. Its diagnosis is more likely in advanced ages, with the older population being the most seen in consultations. Poly(ADP-ribose) inhibitors (PARPi) have changed OC clinical practice and evolution, showing great benefit. However, there is a lack of evidence of PARPi in elderly population that can impact the therapeutic decision and the safety/efficacy. It is necessary to avoid age as limiting factor in PARPis prescription. We conducted a review of the most relevant randomized phase III trials of maintenance PARPi after first-line treatment of advanced OC. We observed the lack of a single criterion for considering older patients, varying among trials. There is a benefit of PARPis in different populations. However, PARPi effect on quality of life is not reported, something of great relevance considering their vulnerability. Measures are needed to benefit older patients to better adapt PARPi treatment.