Re-administering Standard Drug 'PARP Inhibitor'
in Combination with 'Bevacizumab'
The effectiveness of treatment was enhanced in recurrent ovarian cancer patients when a different anticancer drug was administered in combination with the existing targeted therapy.
A joint research team led by Professor Lee Jungyun of the Gynecologic Cancer Center at Yonsei Cancer Center and Professor Cho Hyunwoong of the Department of Obstetrics and Gynecology at Seoul Asan Medical Center announced on the 27th that they observed improved treatment outcomes, including increased progression-free survival, when combining a PARP inhibitor with bevacizumab in patients with platinum-sensitive recurrent ovarian cancer who had relapsed after PARP inhibitor therapy.
This study was a multicenter phase 2 clinical trial led by the Korean Gynecologic Oncology Group (KGOG), with the participation of major institutions in Korea such as Samsung Medical Center and the National Cancer Center. The results were published in the latest issue of the international journal ‘Clinical Cancer Research’ (Impact Factor 11.5).
PARP (Poly ADP-ribose polymerase) inhibitors are targeted anticancer therapies used in ovarian cancer and other malignancies. They work by blocking the DNA repair process that leads to cancer cell growth, serving as a representative example of precision medicine. However, a significant number of patients develop resistance to these inhibitors during treatment, resulting in frequent recurrences of the cancer.
In particular, the response rate to subsequent anticancer therapies is low in patients who experience recurrence after PARP inhibitor treatment, creating a therapeutic gap and highlighting the need for new strategies.
This is where combination therapy with bevacizumab has drawn attention. Bevacizumab is an anti-angiogenic targeted therapy that inhibits the formation of new blood vessels by inducing hypoxic conditions in cancer cells.
When bevacizumab renders cancer cells hypoxic, their DNA repair capabilities are weakened. At this point, the effect of PARP inhibitors, which block DNA repair, is further enhanced. The two drugs act complementarily, creating a biological synergy that increases their anticancer efficacy.
Professor Lee Jungyun’s research team administered a combination of a PARP inhibitor (niraparib) and bevacizumab to 44 ovarian cancer patients who had relapsed after receiving PARP inhibitor therapy, and assessed the results.
As a result, approximately 30 patients (68%) achieved a progression-free survival of 6 months. Progression-free survival refers to the period during which the cancer does not grow following administration of the treatment.
Additionally, the median progression-free survival for more than half of the patients was 11.5 months. This is a significant improvement compared to approximately 4 months previously reported for repeated PARP inhibitor monotherapy.
The treatment effect was particularly pronounced in patients who had achieved complete remission (CR) following their previous anticancer therapy or had maintained a long-term response to platinum-based chemotherapy.
In terms of safety, grade 3 or higher adverse events occurred in 27.3% of cases, but most were manageable through dose adjustment and no new safety issues were identified.
Although the potential for combination therapy with PARP inhibitors and bevacizumab had previously been suggested, clinical studies confirming its efficacy in patients who relapsed after PARP inhibitor treatment have been rare.
Professor Lee Jungyun stated, “This study presents a new maintenance therapy option for patients who have relapsed after PARP inhibitor treatment,” adding, “We have particularly confirmed the clinical value of this combination strategy in patients who had responded well to platinum-based chemotherapy.”
Professor Cho Hyunwoong added, “This is a clinical reconfirmation of a treatment strategy targeting the DNA repair mechanism of cancer,” and emphasized, “It demonstrates the importance of a precision medicine approach tailored to patient characteristics.”
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