PARP Inhibitors in the Management of Ovarian Cancer: ASCO Living Guideline, Version 2026.1.0.

Authors

William P Tew, Christina Lacchetti, Tracey Sheridan Adams, Susana Banerjee, Elizabeth V Connor, Katherine Fuh, Monica B Jones, Stéphanie Lheureux, Ying L Liu, Kathleen Maxian, Kathleen Moore, Carolyn Y Muller, Navya Nair, Clare L Scott, Anil K Sood, Kristin Taylor, Oladapo Yeku, Elise C Kohn

Published in

Journal of clinical oncology : official journal of the American Society of Clinical Oncology. Pages 101200JCO2602412. Oct 27, 2026. Epub Oct 27, 2026.

Abstract

This living guideline provides recommendations on the use of poly(ADP-ribose) polymerase inhibitors (PARPis) in the management of epithelial ovarian cancer (EOC).
An Expert Panel developed recommendations based on a systematic review of randomized controlled trials, and cohort studies evaluating homologous recombination deficiency (HRD) testing and PARPi efficacy and safety.
The updated evidence base comprises 79 publications, including 18 studies evaluating 13 homologous recombination deficiency (HRD) assays and 31 pivotal trials assessing PARPi efficacy and safety. Frontline trials demonstrated progression-free survival benefits. However, later-line treatment and recurrent maintenance trials reported potential overall survival disadvantages.
All patients with newly diagnosed advanced EOC should undergo genetic testing, and HRD tumor testing if BRCA-negative, using FDA-approved or prospectively validated companion diagnostic assays. In advanced EOC, PARPi maintenance should be prioritized for the first clinical remission. Frontline PARPi monotherapy maintenance should be offered after platinum-based chemotherapy response to patients with germline or somatic BRCA1/2 mutations or HRD-positive disease. Olaparib plus bevacizumab maintenance may be offered to patients responding to first-line platinum-based chemotherapy plus bevacizumab who have BRCA1/2 mutations or HRD-positive disease. PARPi maintenance therapy is not recommended for patients with non-BRCAmut HRD-negative tumors or early-stage EOC. In the recurrent setting, PARPi maintenance should be restricted primarily to PARPi-naïve patients with BRCA1/2 mutations responding to second-line or greater platinum-based chemotherapy. Monotherapy PARPi should not be offered for the treatment of recurrent EOC outside clinical trials. Furthermore, PARPi are not recommended for use in combination with chemotherapy, other targeted agents, or immune-oncology agents outside a clinical trial. Clinicians should monitor for serious adverse events, including myelodysplastic syndrome, acute myeloid leukemia, and pulmonary complications.

PMID:
42945508
Bibliographic data and abstract were imported from PubMed on 28 Oct 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.