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Volume 147, Issue 3, Pages 695-704 (December 2017) PARP inhibitors: Clinical utility and possibilities of overcoming resistance Benjamin G. Bitler, Zachary L. Watson, Lindsay J. Wheeler, Kian Behbakht Gynecologic Oncology Volume 147, Issue 3, Pages 695-704 (December 2017) DOI: 10.1016/j.ygyno.2017.10.003 Copyright © 2017 The Authors Terms and Conditions

Fig. 1 PARP inhibitors that are FDA-approved or in clinical development. Gynecologic Oncology 2017 147, 695-704DOI: (10.1016/j.ygyno.2017.10.003) Copyright © 2017 The Authors Terms and Conditions

Fig. 2 Proposed treatment regimen for platinum-sensitive, BRCA1/2-mutated or HRD positive recurrent ovarian cancer. There are now several clinical options of PARPi. As PARPi are more widely utilized there is significant need to delineate, prioritize, and standardize treatment strategies. Depicted is a hypothetical treatment plan for an ovarian cancer patient. Gynecologic Oncology 2017 147, 695-704DOI: (10.1016/j.ygyno.2017.10.003) Copyright © 2017 The Authors Terms and Conditions

Fig. 3 PARPi resistance is mediated through a variety of targetable pathways. The FDA has approved three PARPi for ovarian cancer and as PARPi are commonly prescribed there will be an increase in acquired resistance. Currently, several targetable pathways (HR restoration, PI3K/AKT, miRNA) have been attributed to resistance. Gynecologic Oncology 2017 147, 695-704DOI: (10.1016/j.ygyno.2017.10.003) Copyright © 2017 The Authors Terms and Conditions