Advanced Ovarian Cancer: Understanding the Role of PARP Inhibitor Maintenance Therapy

In Costa Rica, many women facing advanced ovarian cancer complete surgery and chemotherapy with hope for long-term control. Yet we know this disease has a tendency to return even when treatment works well initially. For this reason, an important additional strategy has emerged: maintenance therapy with PARP inhibitors, a group of medications designed to help keep the cancer from coming back.

A recent analysis published in JAMA Network Open showed that PARP inhibitors can extend the time before the cancer progresses, especially in women whose tumors carry BRCA mutations or have homologous recombination deficiency (HRD). These groups demonstrated the most consistent benefit in progression-free survival across several clinical trials.

However, it is essential to understand that no improvement in overall survival has been demonstrated in any subgroup so far. PARP inhibitors may also cause side effects such as fatigue, anemia, or platelet count changes, which means the decision to use them must be highly individualized.

The study also found that women whose tumors lack BRCA mutations or HRD may experience a smaller benefit, highlighting the importance of molecular testing before choosing maintenance therapy.

In Costa Rica, multidisciplinary teams (including gynecologic oncology, medical oncology, and Radiation Oncology) collaborate to determine which patients are most likely to benefit. The goal is always to balance effectiveness, safety, and quality of life. For this reason, discussing your tumor profile, genetic results, and available options with your care team is essential for making informed decisions.