DRG uses cookies to improve your experience on this website. Some of the cookies we use are essential for parts of the website to operate. Please be aware that if you continue without changing your cookie settings, you consent to this. For more information on our use of cookies, please review our cookie policy.

PARP Inhibitor Cheat Sheet for Oncology Strategists

PARP inhibitors are transforming the ovarian cancer market

but standing out is a challenge

  • PARP inhibitors have revolutionized ovarian cancer treatment in the recurrent setting.
  • - Medical Oncologist, United States

Relevant Indications for PARP Inhibitors

Ovarian cancer

  • Maintenance therapy for relapsed platinum-sensitive ovarian cancer regardless of BRCA status; monotherapy for germline or somatic BRCA- mutated ovarian cancer following two or more prior lines of chemotherapy.

Breast cancer

  • Treatment of germline BRCA mutant patients with HER2-negative metastatic breast cancer that have been previously treated with chemotherapy in any setting.

Prostate and pancreatic cancer

  • PARP inhibitors are in late-phase development for these indications.

Total 2017 US revenue for ovarian cancer: $305.5M
Estimated 2026 US revenue for ovarian, breast, prostate and pancreatic cancer: $2.2 billion

Key Current Players

AstraZeneca’s Lynparza

(olaparib)

Clovis Oncology’s Rubraca

(rucaparib)

Tesaro’s Zejula

(niraparib)

Notable Emerging Therapies

AbbVie’s veliparib

Pfizer’s talazoparib

"With three PARPs already approved for ovarian cancer and more set to enter the market, the key issue for developers will be finding ways to ensure that their PARP inhibitor stands out from the crowd.

In the absence of meaningful differences in efficacy and toxicity, non-clinical factors such as time-to-market, price and managed entry agreements will play a key role in securing market share.”

- Carolina do Pazo, Business Insights Analyst, DRG Oncology

The eventual market leader will need strong evidence or else find innovative ways to win in pricing, contracting or marketing

  • Without a head-to-head comparison we don’t know which PARP inhibitor is better in terms of efficacy, particularly when they have all shown fairly good data.
  • - Medical Oncologist, United States

Challenges Facing PARP Inhibitors

Clinical Challenges

  • More mature overall survival data is needed
  • Safety concerns: hematological toxicity is a common adverse event of PARP inhibitor treatment and patients may be at risk of developing a secondary hematological malignancy (e.g., MDS, AML)

Non-clinical Challenges

  • Premium price and long duration treatments in the maintenance settings may increase payer enforced cost controls resulting in accessibility issues
  • Use of PARP inhibitors can be limited to patients with homologous recombinational repair mutated genes

Key Points Developers Need to Address

Single-arm studies and surrogate endpoints do not fully provide the clinicians with the information necessary to make treatment decisions.

More follow-up studies for PARP inhibitors are needed as evidence of overall survival benefit ultimately has the greatest influence on physician prescribing decisions.

Indirect comparison of the PARP inhibitors based on the current evidence is difficult, so head-to-head assessments are needed.

Developers must find ways to differentiate their agent from the competition. In the absence of clinical differentiators, pricing, managed entry agreements and marketing will be crucial to optimize market uptake.

Download this cheat sheet as a PDF

Visit DRGOncology.com for more expert resources to keep you on top of the latest updates and innovations in the oncology landscape and how it impacts your decisions.

Learn more about our ovarian cancer and breast cancer research.