Updated data from the ATHENA-MONO study, presented at ESGO 2025 Annual Meeting, has confirmed that rucaparib, a maintenance treatment, continues to provide significant post-progression survival benefits for patients with newly diagnosed advanced high-grade ovarian cancer (HGOC). The study, conducted by Sharad Ghamande and colleagues, followed patients for four years after initial treatment, reinforcing the efficacy of rucaparib in this challenging patient population.
Rucaparib is an anticancer drug and a poly (ADP-ribose) polymerase (PARP) inhibitor that works by blocking cancer cells’ ability to repair DNA damage, leading to their death. The trial included patients with stage III–IV HGOC who had completed cytoreductive surgery and 4–8 cycles of first-line platinum-doublet chemotherapy, with or without bevacizumab. Participants were randomly assigned to receive either oral rucaparib 600mg twice daily or a placebo. The primary endpoint was progression-free survival (PFS), with secondary endpoints including overall survival and safety. Exploratory factors included second event of progression (PFS2), chemotherapy-free interval (CFI), time to first subsequent treatment (TFST), and time to second subsequent treatment (TSST).
In this trial two different populations were analysed; a homologous recombination deficient (HRD) and intent-to-treat (ITT). The former is a specific subgroup of patients whose cancer cells have a genetic defect in their DNA repair mechanism, making them more susceptible to treatments targeting DNA repair, while the latter includes all patients enrolled in the study, regardless of their genetic profile or adherence to the treatment protocol. The updated analysis, with a data cutoff in May 2024, showed consistent trends favouring rucaparib over placebo in both the homologous recombination deficient (HRD) and intent-to-treat (ITT) populations.
Key findings showed longer PFS2 (HR: 0.74), CFI (HR: 0.51), and TFST (HR: 0.55) with rucaparib compared to placebo. In the ITT population, rucaparib also improved PFS2 (HR: 0.72), CFI (HR: 0.54), and TFST (HR: 0.54) compared to placebo. TSST trended longer in the HRD group (HR: 0.69) and was significantly longer in the ITT group (HR: 0.68).
These results further validate rucaparib’s role in maintaining treatment benefit after first-line chemotherapy and suggest continued efficacy in managing advanced ovarian cancer.
Helena Bradbury, EMJ
Reference
Ghamande S et al. PSA-063: ATHENA-MONO Post-progression survival data update in patients with newly diagnosed advanced ovarian cancer. Presented at ESGO 2025 Annual Meeting; Feb 20-23; Milan, Italy.
