Oops, you're using an old version of your browser so some of the features on this page may not be displaying properly.

MINIMAL Requirements: Google Chrome 24+Mozilla Firefox 20+Internet Explorer 11Opera 15–18Apple Safari 7SeaMonkey 2.15-2.23

ESMO E-Learning: Management of BRCA-Mutated Ovarian Cancer - An Update

New E-Learning module by Prof Ledermann is now available. Watch the presentation and take the CME test today!

E-learning video block

This content is for ESMO members only.



Download slides

Learning objectives

  1. To understand the importance of BRCA mutations in the pathogenesis of ovarian cancer​
  2. To understand how knowledge of BRCA mutations has opened the door to precision medicine treatment for ovarian cancer​
  3. To provide an overview of the mechanisms of action of PARP inhibitors and how maintenance treatment with PARPi has changed the treatment of ovarian cancer​
  4. To provide an overview of the complexity of the outcome assessment of treatment with PARPi in recurrent ovarian cancer​
  5. To provide an overview of PARPi toxicity and its management​
  6. To provide an overview of how the results of front line PARPi treatment in women with BRCA-mutated ovarian cancer has changed clinical practice


In this E-Learning module, the author explains phenotypic features of BRCA-mutated ovarian cancer, the mechanisms of repair of DNA damage, and the increased sensitivity of BRCA-positive tumours to PARP inhibition (PARPi). There is an explanation of tests used to assess for PARPi activity and how maintenance strategies have led to a change in management of women with ovarian cancer.

The author explains PARPi activity in women with BRCA-mutated and non-BRCA-mutated recurrent high grade serous ovarian cancer after a response to platinum-based therapy using a maintenance strategy, shows results from Study 19 BRCA- and non-BRCA-mutated subset analysis, outcomes by somatic or germline BRCA mutation, findings from SOLO-2 study of maintenance olaparib in women with BRCA-mutated platinum-sensitive recurrent ovarian cancer, findings from NOVA, ARIEL-3 and NORA studies with maintenance niraparib and rucaparib in BRCA-mutated platinum-responsive recurrent ovarian cancer, and looks into survival data and long-term responders.

The author then provides an overview of the results from SOLO3 study of olaparib monotherapy versus chemotherapy in women with BRCA-mutated recurrent ovarian cancer, the results of ARIEL4 study and reasons why progression-free survival not always translates into an overall survival benefit. After looking into rechallenge with chemotherapy in women with BRCA mutations recurring after SOLO2, the author goes into explanation of potential mechanisms for PARP resistance.

The next chapter is devoted to safety profile of different PARPi, dose reductions and discontinuation due to side effects, principles of management of PARPi toxicity, analysis of incidence of MDS/AML with PARPi in recurrent ovarian cancer, quality-of-life issues, and time without symptoms and toxicity.

In the following chapter, the author explains the introduction of maintenance with a PARPi in front-line treatment of women with high-grade ovarian cancer, provides overview of results from SOLO1 study, then the results from PAOLA- 1 study in tBRCA-mutated subpopulations receiving bevacizumab with or without olaparib, the findings in BRCA-mutated populations in PRIMA study with niraparib and the ATHENA-mono study with rucaparib. The  toxicities and tolerability of treatment is discussed.

The next part of the module is devoted to maintenance PARPi beyond BRCA mutation in women with platinum-responsive recurrent ovarian cancer. The author also touches trials combining PARPi with immune checkpoint inhibitors with or without bevacizumab in front-line treatment. The final part of the module is devoted to providing the relevant algorithms and recommendations from the ESMO Clinical Practice Guidelines.

Declaration of interest

Jonathan Ledermann has reported:
Financial Interests:
Advisory Board, Speaker Fees, Personal: AstraZeneca, Clovis Oncology, GSK.
Advisory Board, Personal: Artios Pharma, Eisai, Merck/MSD, VBL Therapeutics, Bristol Myers Squibb, Nuvation, Ellipses, Immunogen, Miltenyi, Novocure, Immagene.
Invited Speaker, Personal, Speaker Fees: Neopharm.
Other, Personal, Independent Data Monitoring Committee: Mersana, Sutro Bio.
Research Grant, Institutional, Clinical Research University: AstraZeneca, MSD/Merck.
Non-Financial Interests:
European Society of Gynaecological Oncology, Leadership Role, Vice President ( 2019-2021).
ESMO, Officer, Chair Gynaecological Clinical Practice Guidelines.
Sage Publishing, Other, Associate Editor: Therapeutic Advances in Medical Oncology.

Last update: 28 Mar 2024

This site uses cookies. Some of these cookies are essential, while others help us improve your experience by providing insights into how the site is being used.

For more detailed information on the cookies we use, please check our Privacy Policy.

Customise settings
  • Necessary cookies enable core functionality. The website cannot function properly without these cookies, and you can only disable them by changing your browser preferences.