David O’Malley, MD, Discusses PFS Benefit of Maintenance Rucaparib Regardless of Surgery Outcome in Newly Diagnosed Ovarian Cancer

Data from the phase 3 ATHENA-MONO study indicated that maintenance rucaparib yielded progression-free survival benefit vs placebo across all subgroups in a population of patients newly diagnosed ovarian cancer, according to David O’Malley, MD.

In a conversation with CancerNetwork® during the 2022 Annual Global Meeting of the International Gynecologic Cancer Society (IGCS), David O’ Malley, MD, director of the Division of Gynecologic Oncology and professor of the Department of Obstetrics and Gynecology at The Ohio State University James Comprehensive Cancer Center, discussed the results of the phase 3 ATHENA-MONO study (NCT03522246), which highlighted a promising survival benefit in patients with newly diagnosed ovarian cancer across multiple subgroups following treatment with frontline maintenance rucaparib (Rubraca).

In the trial, rucaparib maintenance produced higher PFS vs placebo in the intent-to-treat (ITT) and homologous recombination deficiency (HRD) populations regardless of whether patients received R0 or non-R0 cytoreductive surgery. O’Malley went into further detail about the trial’s subgroup analysis, which indicated that the highest-risk patients may derive the most benefit.


When we look at the subgroup analysis, both those who had R0 resections vs those who had not, the entire population benefited from rucaparib therapy. The greatest magnitude of benefit was actually in those patients [who had] the highest [disease] risk: the non-R0 resection subgroup. But as we looked at those who had a complete resection, the median PFS were markedly better vs those at higher risk or non-R0 patients. In the patients who had a partial response to platinum-based doublet chemotherapy, the magnitude of benefit was higher with regard to those receiving rucaparib therapy. But the overall low-risk population or those who had a complete response—which were admittedly small numbers—markedly benefited from rucaparib therapy. It's very important that we identify patients who are going to benefit the most from the therapies we are recommending like rucaparib. However, all patients across the entire population benefited with rucaparib therapy compared with placebo.


O’Malley D, Christopoulou A, Lim MC, et al. Efficacy analysis by disease risk subgroup for the phase 3 ATHENA-mono study (GOG-3020/ENGOT-ov45) evaluating rucaparib maintenance treatment in patients with newly diagnosed ovarian cancer. Presented at: 2022 International Gynecologic Cancer Society Annual Meeting; September 29-October 1, 2022; New York, NY. Abstract O026. Accessed September 30, 2022.