A 55-year-old woman is diagnosed with advanced high-grade serous ovarian carcinoma (HGSOC). She is found to carry a germline BRCA1 mutation. Which maintenance therapy is MOST appropriate after platinum–taxane chemotherapy, based on current guidelines?
- A Bevacizumab alone
- B Tamoxifen
- C Olaparib (PARP inhibitor) ✓
- D Megestrol acetate
Correct answer: C. Olaparib (PARP inhibitor)
Explanation
PARP inhibitors (olaparib, niraparib, rucaparib) exploit homologous recombination deficiency in BRCA-mutated tumours through synthetic lethality. The SOLO-1 trial demonstrated that olaparib maintenance significantly prolongs progression-free survival in BRCA1/2-mutated advanced ovarian cancer after first-line platinum response. Bevacizumab is an anti-VEGF antibody used in maintenance but is not specifically indicated over PARP inhibitors in BRCA-mutated disease. Tamoxifen and megestrol are not standard for HGSOC.
Reference: Shaw's Textbook of Gynaecology, 17th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.