A 62-year-old woman with stage IIIC high-grade serous ovarian carcinoma achieves complete cytoreduction followed by carboplatin-paclitaxel chemotherapy plus bevacizumab. She is found to be BRCA1-mutated. According to SOLO-1 trial data, which maintenance therapy offers the greatest reduction in disease progression at 3 years?
- A Continued bevacizumab maintenance
- B Letrozole hormonal maintenance
- C Olaparib maintenance for 2 years ✓
- D Weekly paclitaxel dose-dense maintenance
Correct answer: C. Olaparib maintenance for 2 years
Explanation
The SOLO-1 trial demonstrated that olaparib (PARP inhibitor) maintenance for 2 years in BRCA1/2-mutated advanced ovarian cancer after complete/partial response to first-line platinum-taxane chemotherapy resulted in a 70% reduction in risk of disease progression or death compared to placebo (HR 0.30). At 3 years, 60% of olaparib-treated patients remained progression-free versus 27% on placebo. Bevacizumab maintenance has benefit (ICON7, GOG-218) but the magnitude in BRCA-mutated patients does not match olaparib.
Reference: Shaw's Textbook of Gynaecology, 17th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.