HRD testing finds favor among experts for ovarian cancer PARP inhibitors despite broad labels, potential impact on market penetration - experts

30 Jun 2017

Despite the broad label received in recent ovarian cancer approvals, experts said they are still considering using homologous recombination deficiency (HRD) tests to whittle down eligible patients before treatment.

Tesaro’s (NASDAQ:TSRO) Zejula (niraparib) was the first PARP inhibitor to be given a broad label for second-line ovarian cancer maintenance therapy, while Clovis Oncology’s (NASDAQ:CLVS) Rubraca (rucaparib) is also anticipated to have a similar label.

Despite Zejula’s statistically significant PFS improvement in all patients and resultant broad label, the relatively smaller benefit seen in HRD-negative patients has made them see value in testing patients for HRD to guide treatment decisions for Zejula as well as upcoming PARP inhibitors, experts said.

Analysts have been forecasting PARP inhibitor revenues based on use as per label, but experts said such a label may not be indicative of eventual market penetration given the option to use HRD tests to limit use to likely responding patient subsets, as opposed to all postplatinum ovarian cancer patients in the maintenance setting.

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