The discussant of the fuzuloparib abstract at the Society of Gynecologic Oncology meeting was Thomas Herzog, MD, Deputy Director of the University of Cincinnati (UC) Cancer Center and Professor of Obstetrics and Gynecology at the UC College of Medicine. He said that these data have already led to the approval of fuzuloparib in China and that the results are comparable to other recent randomized, phase III studies of poly (ADP-ribose) polymerase (PARP) inhibitors in platinum-sensitive ovarian cancer.

Thomas Herzog, MD

“Other than the SOLO-2 trial [olaparib], which only enrolled patients with germline BRCA-mutated recurrent disease, the control arms of ARIEL3 [rucaparib], NOVA [niraparib], and this trial were all very similar to one another [in outcomes], which is reassuring,” said Dr. Herzog. “Interestingly, patients with germline BRCA-mutated disease had the same progression-free survival of 12.9 months in the intent-to-treat population.”

Dr. Herzog also compared the rates of toxicity among PARP inhibitors. The grade 3 or 4 hemoglobin toxicity in the fuzuloparib study was close to that of niraparib, whereas grade 3 or 4 thrombocytopenia appeared intermediate between niraparib and other approved PARP inhibitors. However, fuzuloparib had the lowest treatment discontinuation rate.

“Overall, this trial was very well done and enrolled a large number of patients,” he said. “Data were immature for secondary endpoints including overall survival, and long-term safety data are still immature, however.”

Dr. Herzog concluded: “Ultimately, I think it would be interesting to tease out why we didn’t see a bigger difference in efficacy between germline and non-germline BRCA-mutated disease in this trial.” 

DISCLOSURE: Dr. Herzog has served in a leadership role for the GOG Partners Board of Directors; and has served as a consultant or advisor to Aravive, AstraZeneca, Caris, Clovis Oncology, Eisai, GSK, Johnson & Johnson, Merck, and Roche/Genentech.