标题：New perspective on maintenance therapies for platinum-sensitive recurrent ovarian cancer in women with germline and somatic mutations in BRCA1 and BRCA2 genes
摘要：Ovarian cancer (OC) is the seventh most common cancer in women. Although women diagnosed with OC are usually
treated frontline with platinum-based chemotherapy, most of them relapse once treatment is halted. Therefore,
maintenance therapies have been developed to secure the response and delay further chemotherapy. There are
two established maintenance therapies for women affected by platinum-sensitive recurrent OC: bevacizumab, a
humanized monoclonal antibody targeting vascular endothelial growth factor, and olaparib, an inhibitor of poly
(adenosine diphosphate [ADP]-ribose) polymerase (PARPi). Loss-of-function mutations in genes in the homologous
recombination pathway, especially BRCA1 and BRCA2, predict higher rates of platinum sensitivity, better overall
survival (OS), and better response to PARPi in women with OC. Among patients with platinum-sensitive recurrent
OC, a BRCA mutation is the first genetically defined predictive marker for targeted therapy, since these patients are
most likely to benefit from treatment with a PARPi, such as olaparib. In patients with platinum-sensitive recurrent
OC without a BRCA mutation, bevacizumab currently seems to be the best maintenance option. Women with OC
are progressively more routinely screened for germline BRCA mutations, and the implication of somatic BRCA
mutations is increasingly being recognized in OC. Therefore, the recommendations should be updated to reflect the
importance of both types of mutations. Together, these data highlight the fact that treatment of recurrent OC can
be optimized using genomic contributions to individualize therapy and to improve treatment response.
