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PARP inhibitors in non-ovarian gynecologic cancers

Italo Fernandes,Rania Chehade,Helen Mackay

THERAPEUTIC ADVANCES IN MEDICAL ONCOLOGY(2024)

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Abstract
Poly(ADP-ribose) polymerase (PARP) inhibitors (PARPis) have transformed the treatment of ovarian cancer, particularly benefiting patients whose tumors harbor genomic events that result in impaired homologous recombination (HR) repair. The use of PARPi over recent years has expanded to include subpopulations of patients with breast, pancreatic, and prostate cancers. Their potential to benefit patients with non-ovarian gynecologic cancers is being recognized. This review examines the underlying biological rationale for exploring PARPi in non-ovarian gynecologic cancers. We consider the clinical data and place this in the context of the current treatment landscape. We review the development of PARPi strategies for treating patients with endometrial, cervical, uterine leiomyosarcoma, and vulvar cancers. Furthermore, we discuss future directions and the importance of understanding HR deficiency in the context of each cancer type. PARP inhibitors in non-ovarian gynecologic cancersPoly(ADP-ribose) polymerase (PARP) inhibitors (PARPi) have transformed the way ovarian cancer is treated, especially for patients whose tumors have specific genetic issues affecting their ability to repair DNA. Over time, PARPi are being used for certain groups of patients with breast, pancreatic, and prostate cancers. More recently, their potential to help people with other types of gynecologic cancers than ovarian have been studied. In this review, we explore the reasons behind looking into PARPi for these non-ovarian gynecologic cancers. We analyze the clinical data and compare it to the current treatment options available, focusing on endometrial, cervical, uterine leiomyosarcoma, and vulvar cancers. Additionally, we discuss about future directions and stress the importance of understanding the specific DNA repair context for each type of cancer. Especially, we discuss the tests that aims to define who may benefit from the drug, with focus on the homologous recombination deficiency.
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Key words
clinical trials,homologous recombination deficiency,novel therapies,PARP inhibitor,predictive biomarker
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