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Ovarian Cancer — SCE Medical Oncology MCQ

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HardGynaecological CancersOvarian CancerSCE Medical Oncology

At first relapse, a BRCA1/2-negative high-grade fallopian-tube carcinoma responds partially to carboplatin-gemcitabine after a 13-month treatment-free interval. Including initial therapy, two platinum courses have been completed and no PARP inhibitor has been used. Which maintenance route fits NICE TA784?

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Correct answer: B — Niraparib maintenance because she has responded after at least two platinum courses

TA784 recommends niraparib after a complete or partial response to the latest platinum course in relapsed platinum-sensitive high-grade ovarian, fallopian-tube or primary peritoneal cancer. In BRCA-wild-type disease, at least two previous platinum courses are required, which the initial and relapse regimens provide. Platinum sensitivity alone does not create a relapsed olaparib indication in BRCA-wild-type disease; first-line rucaparib and olaparib-bevacizumab have different biomarker and treatment-context requirements, while observation overlooks an eligible maintenance option.

Reference: NICE TA784 niraparib maintenance for relapsed platinum-sensitive ovarian cancer (Published April 2022): https://www.nice.org.uk/guidance/ta784/chapter/1-Recommendations