skip to main content

PARP Rechallenge — SCE Medical Oncology MCQ

Instant feedback + full explanation. One question, done properly.

HardGynaecological CancersPARP RechallengeSCE Medical Oncology

A 55-year-old woman with high-grade serous ovarian cancer has a BRCA2 germline mutation. After completing first-line platinum-taxane chemotherapy and olaparib maintenance (2 years), she develops platinum-sensitive relapse 18 months after stopping olaparib. Can she receive a second course of PARP inhibitor?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: D — PARP inhibitor rechallenge after a PARP-free interval is being evaluated in clinical trials (e.g. OReO/OREO); preliminary data suggest some patients with BRCA-mutant cancers may benefit from rechallenge, particularly if the platinum-free interval is long

The OReO/ENGOT Ov-38 trial evaluated PARP inhibitor maintenance rechallenge in platinum-sensitive relapsed ovarian cancer after prior PARPi. Results showed PFS benefit for olaparib rechallenge vs placebo in the BRCA-mutant cohort, supporting rechallenge in selected patients. The non-BRCA cohort showed more modest benefit. The platinum-free and PARP-free intervals influence expected benefit. MDS/AML risk with cumulative PARPi exposure must be monitored. This is an evolving area of clinical practice.

Reference: ESMO 2024 Ovarian Cancer; OReO Pujade-Lauraine et al Ann Oncol 2021