Dr. Pothuri on the Role of Maintenance Therapy in BRCA+ Ovarian Cancer

Bhavana Pothuri, MD, professor, Department of Obstetrics and Gynecology, NYU School of Medicine, director of gynecologic oncology clinical trials, NYU Langone Health’s Perlmutter Cancer Center, discusses the role of maintenance therapy in BRCA-positive ovarian cancer.

Currently, maintenance therapy should be considered for all patients with ovarian cancer irrespective of BRCA mutational status, says Pothuri. The type of maintenance therapy administered is dependent on whether the patient received bevacizumab (Avastin) in the frontline setting, Pothuri explains.

As such, patients who received frontline bevacizumab should continue bevacizumab in the maintenance setting with added olaparib (Lynparza), Pothuri says. Typically, up-front bevacizumab is given to patients with bulky or stage IV disease, adds Pothuri. Patients who did not receive frontline bevacizumab will receive olaparib alone as maintenance therapy, Pothuri says.

Notably, patients who harbor BRCA mutations or have homologous recombination deficient disease appear to derive additional benefit from maintenance therapy, Pothuri explains. As such, shared­–decision making, as well as genetic testing, is critical to optimize maintenance therapy in this patient population, concludes Pothuri.