New Engl. J. Med. https://doi.org/10.1056/nejmoa1910962 (2019)

The PARP inhibitor niraparib demonstrates clinical benefit in patients with ovarian cancer, regardless of the functional status of the DNA repair machinery.

Mutations in the BRCA gene compromise the capacity of tumors to correct DNA breaks through a process known as homologous recombination and have been linked to the efficacy of PARP inhibitors in patients with ovarian cancer. It is not known, however, whether these agents are also effective in tumors with other repair deficiencies or in unselected patients.

Antonio González-Martín and his collaborators find in the PRIMA/ENGOT-OV26/GOG-3012 phase 3 clinical trial that niraparib extends progression-free survival in newly diagnosed patients with advanced ovarian cancer. This benefit is observed in patients whose tumors have HRD due to BRCA mutations and to other mechanisms, and also in patients without evidence of HRD.