Discussion
toxicities, thrombocytopenia, BRCA mutated tumors, neutropenia
NEUTROPENIA, RECURRENT OVARIAN CANCER, THROMBOCYTOPENIA, RECURRENT DISEASE, ONCOLOGY, CYTOTOXICITY
These phase II clinical trials investigated a promising novel agent, thought to be a PARP inhibitor with potential synergy with gemcitabine and carboplatin in 2 cohorts of patients with recurrent ovarian cancer. Subsequent studies have clarified the lack of even additive benefit, and the mechanism of in vitro cytotoxicity observed with iniparib remains obscure.Sanofi purchased iniparib from BiPar Sciences Inc. in 2009, 2 years before we presented these data at the American Society of Clinical Oncology (ASCO) annual meeting, at a cost of up to $500 million if iniparib met its development targets.Gemcitabine and carboplatin remains a standard combination with proven efficacy in platinum sensitive recurrent disease,It is noteworthy that almost one quarter of the platinum resistant group carried a gIn summary, GCI produced a confirmed ORR of 66% in the platinum sensitive patient population and 26% in the platinum resistant population. The GCI combination was generally well tolerated despite high incidence of thrombocytopenia and neutropenia, with no new toxicities, and safety profiles consistent with those observed in prior clinical studies with GC. Higher than expected response rates should be anticipated when there are selective pressures, such as the promise of benefit from a new investigational agent, heralded as a first in class breakthrough, that disproportionately draws in more patients with BRCA mutated tumors. For example, the SOLO3 trial which evaluated the PARP inhibitor, olaparib as a single agent against non-platinum based single agent chemotherapy in patients with 