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CC BY 4.0 · Brazilian Journal of Oncology 2023; 19: e-20230400
DOI: 10.5935/2526-8732.20230400
Review Article
Clinical Oncology

PARP inhibitors as first-line maintenance therapy in ovarian cancer: recommendations from an expert panel from Brazil

Inibidores de PARP como terapia de manutenção de primeira linha no câncer de ovário: recomendações de um painel de especialistas do Brasil
Aknar FC Calabrich 
1   Clinica AMO, Salvador - BA, Brazil
2   Brazilian Group of Gynecologic Oncology, São Paulo - SP, Brazil
,
Daniele Xavier Assad 
3   Hospital Sírio Libanês, Brasilia - DF, Brazil
,
Graziela Dal-Molin 
4   Hospital Beneficência Portuguesa de São Paulo, São Paulo - SP, Brazil
,
Andreia C Melo 
5   Brazilian National Cancer Institute, Rio de Janeiro - RJ, Brazil
6   Grupo Oncoclínicas, São Paulo - SP, Brazil
,
Angelica Nogueira-Rodrigues 
2   Brazilian Group of Gynecologic Oncology, São Paulo - SP, Brazil
7   Federal University of Minas Gerais, Belo Horizonte - MG , Brazil
,
Karime Kalil 
8   Johns Hopkins Bloomberg School of Public Health, Baltimore - MD, United States
,
Andrea PG Guimarães 
9   ACCamargo Cancer Center, São Paulo - SP, Brazil
,
Michelle Samora Almeida 
10   Universidade Federal de São Paulo, São Paulo - São Paulo - SP, Brazil
11   HCOR Oncologia, São Paulo - SP, Brazil
,
Carla Rameri de-Azevedo 
12   Rede D’Or, Recife - PE, Brazil
,
Daniela de-Freitas 
13   Hospital Sírio Libanês, São Paulo - SP, Brazil
,
Alessandra Menezes Morelle 
14   Hospital Moinhos de Vento, Porto Alegre - RS, Brazil
,
Ana Carolina Leite 
15   Rede D’Or, Fortaleza - CE, Brazil
,
Marcela Crosara 
16   Rede D’Or, Brasília - DF, Brazil
,
João Soares Nunes 
17   Hospital Erasto Gaertner, Curitiba - PR, Brazil
,
Poliana Signorini 
18   Fundação Centro de Controle de Oncologia do Amazonas - FCECON, Manaus - AM, Brazil
,
Eduardo Cronemberger 
19   Centro Regional Integrado de Oncologia - CRIO, Fortaleza - CE, Brazil
,
Rachel Cossetti 
20   Rede D’Or, São Luíz - MA, Brazil
,
Rodrigo Guindalini 
21   Instituto D’Or de Pesquisa e Ensino (IDOR), São Paulo - SP, Brazil
,
Eduardo Paulino 
2   Brazilian Group of Gynecologic Oncology, São Paulo - SP, Brazil
5   Brazilian National Cancer Institute, Rio de Janeiro - RJ, Brazil
,
Fernando C Maluf 
4   Hospital Beneficência Portuguesa de São Paulo, São Paulo - SP, Brazil
22   Hospital Israelita Albert Einstein, São Paulo - SP, Brazil
› Author Affiliations Financial support: This consensus was funded by AstraZeneca and GlaxoSmithKline but there was no influence on the board’s decision or the content of this article.
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ABSTRACT

To report consensus recommendations on the current role of poly(ADP-ribose) polymerase (PARP) inhibitors in the front-line management of patients with epithelial ovarian cancer (EOC) in the healthcare setting of Brazil. The expert panel convened in March 2021 and comprised 20 medical oncologists focus on gynecological oncology. The panel answered anonymously and based on scientific evidence a total of 67 questions. The panel reached consensus (at least 75% of votes for the same recommendation) or majority vote (50% to 74.9%) for the majority of questions that addressed: (1) who and when to test for BRCA mutations or homologous recombination deficiency (2) what test should be used; (3) when should maintenance PARP inhibitor therapy be indicated; (4) which PARP inhibitor should be used; (5) when should bevacizumab be combined; and (6) toxicity management. The current recommendations may help Brazilian practitioners to improve the use of PARP inhibitors in front-line management of EOC.

RESUMO

Relatar recomendações consensuais sobre o papel atual dos inibidores da poli(ADP-ribose) polimerase (PARP) no tratamento de primeira linha de pacientes com câncer epitelial de ovário (CEO) no ambiente de saúde do Brasil. O painel de especialistas foi convocado em março de 2021 e composto por 20 médicos oncologistas com foco em oncologia ginecológica. O painel respondeu anonimamente e com base em evidências científicas a um total de 67 perguntas. O painel chegou a consenso (pelo menos 75% dos votos para a mesma recomendação) ou maioria de votos (50% a 74,9%) para a maioria das questões que abordaram: (1) quem e quando testar mutações BRCA ou deficiência de recombinação homóloga; (2) qual teste deve ser usado; (3) quando deve ser indicada a terapia de manutenção com inibidores de PARP; (4) qual inibidor de PARP deve ser usado; (5) quando o bevacizumabe deve ser combinado; e (6) gerenciamento de toxicidade. As recomendações atuais podem ajudar os médicos brasileiros a melhorar o uso de inibidores de PARP na linha de frente do manejo de CEO.

Keywords:

Carcinoma - Ovarian epithelial - Poly(ADP-ribose) polymerase inhibitors - Consensus

Descritores:

Carcinoma - Epitelial ovariano - Inibidores de poli(ADP-ribose) polimerase - Consenso


Publication History

Received: 09 January 2023

Accepted: 13 January 2023

Article published online:
23 February 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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Bibliographical Record
Aknar FC Calabrich, Daniele Xavier Assad, Graziela Dal-Molin, Andreia C Melo, Angelica Nogueira-Rodrigues, Karime Kalil, Andrea PG Guimarães, Michelle Samora Almeida, Carla Rameri de-Azevedo, Daniela de-Freitas, Alessandra Menezes Morelle, Ana Carolina Leite, Marcela Crosara, João Soares Nunes, Poliana Signorini, Eduardo Cronemberger, Rachel Cossetti, Rodrigo Guindalini, Eduardo Paulino, Fernando C Maluf. PARP inhibitors as first-line maintenance therapy in ovarian cancer: recommendations from an expert panel from Brazil. Brazilian Journal of Oncology 2023; 19: e-20230400.
DOI: 10.5935/2526-8732.20230400
 

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