Adding the PARP inhibitor olaparib to bevacizumab maintenance therapy for ovarian cancer among patients who have responded to platinum-taxane chemotherapy improves outcomes regardless of when surgery took place, according to an analysis of the seminal PAOLA-1 data that was to be presented at the Society for Gynecologic Oncology 2020 annual meeting. While sample sizes were too small to confirm benefits among patients with residual disease after surgery, numerical trends favored olaparib. As previously reported, in PAOLA-1 the addition of olaparib to bevacizumab maintenance therapy in patients with ovarian cancer was associated with a longer investigator-assessed progression-free survival (PFS; median 22.1 vs 16.6 months). Among patients who had upfront surgery, median PFS was 29.6 months with olaparib and 18.2 months with placebo (hazard ratio [HR], 0.52). Among those who had interval surgery, results were similar, with a median PFS of 21.4 versus 16.7 months (HR, 0.66). In patients who had upfront surgery and no residual disease, median PFS was 39.3 months with olaparib and 22.1 months with placebo (HR, 0.47). In patients who had interval surgery and no residual disease, median PFS was 22.1 versus 17.7 months (HR, 0.61). PFS was not significantly improved with the addition of olaparib among patients who had residual disease, regardless of whether they had upfront or interval surgery, but numerically still favored olaparib. (HRs, 0.74 and 0.70, respectively).
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