Five-year data from the SOLO-1 Phase III trial is the longest
follow-up analysis for any PARP inhibitor in the 1st-line
maintenance setting
AstraZeneca and Merck & Co., Inc., (Merck: known as MSD
outside the US and Canada) today announced that LYNPARZA
demonstrated a long-term progression-free survival (PFS) benefit
versus placebo as a 1st-line maintenance treatment in patients with
newly diagnosed, advanced BRCA-mutated (BRCAm) ovarian cancer who
had a complete or partial response following platinum-based
chemotherapy.
Ovarian cancer ranks fifth in cancer deaths among women in the
U.S., and in 2020, an estimated 21,750 women in the U.S. will
receive a new diagnosis and about 13,940 women will die from
ovarian cancer.1
Five-year follow-up data from the Phase III SOLO-1 trial showed
LYNPARZA reduced the risk of disease progression or death by 67%
(based on a hazard ratio [HR] of 0.33; 95% confidence interval [CI]
0.25-0.43) and improved PFS to a median of 56.0 months versus 13.8
months for placebo. At five years, 48.3% of patients treated with
LYNPARZA remained free from disease progression versus 20.5% on
placebo. The median duration of treatment with LYNPARZA was 24.6
months versus 13.9 months with placebo.
Susana Banerjee, one of the investigators from the SOLO-1 trial
and Consultant Medical Oncologist at The Royal Marsden NHS
Foundation Trust and Reader at the Institute of Cancer Research,
London, said: “For patients with newly diagnosed BRCA-mutated
advanced ovarian cancer, the benefit derived from two years of
maintenance treatment with LYNPARZA continued long after treatment
ended. After five years, almost half of these women were free of
cancer progression. These results represent a significant step
forward in the treatment of BRCA-mutated ovarian cancer.”
José Baselga, Executive Vice President, Oncology R&D, said:
“Once a patient’s ovarian cancer recurs, it has historically been
incurable. Even at an advanced stage, we have shown that
maintenance treatment with LYNPARZA can help patients achieve
sustained remission. Today’s results further underline the critical
importance of identifying a patient’s biomarker status at the time
of diagnosis to be able to offer a treatment that may help delay
disease progression.”
Roy Baynes, Senior Vice President and Head of Global Clinical
Development, Chief Medical Officer, Merck, said: “This is the first
trial of a PARP inhibitor to read out a five year follow up and
showed LYNPARZA improved progression-free survival to over four and
a half years versus 13.8 months with placebo following response to
1st-line platinum-based chemotherapy. This latest data represents a
major and significant milestone in a disease which has historically
had such a poor prognosis.”
Summary of results
Progression-free survival
Recurrence-free survival*
LYNPARZA
N=260
Placebo
N=131
LYNPARZA
N=189
Placebo
N=101
Events, n (%)
118 (45)
100 (76)
79 (42)
74 (73)
Median, m
56.0
13.8
NR
15.3
HR (95%CI)
0.33 (0.25–0.43)
0.37 (0.27–0.52)
Patients progression or recurrence free
at timepoint, % (Kaplan-Meier estimates)
1y
87.7
51.4
91.0
58.0
2y
73.6
34.6
77.2
39.0
3y
60.1
26.9
64.0
28.9
4y
52.3
21.5
55.2
23.0
5y
48.3
20.5
51.9
21.8
*Defined post hoc as time from
randomization to disease recurrence* or death for patients in
complete response to platinum-based chemotherapy at baseline;
patients had CR at baseline based on electronic case report form
data. CI, confidence interval; HR, hazard ratio; NR, not
reached
The safety profile of LYNPARZA was consistent with previous
observations. The most common adverse events (AEs) ≥20% were nausea
(77%), fatigue/asthenia (63%), vomiting (40%), anemia (39%) and
diarrhea (34%). The most common ≥ grade 3 AEs were anemia (22%) and
neutropenia (9%). Twelve percent of patients on LYNPARZA
discontinued treatment due to an AE.
The results were presented on Friday, September 18, during the
2020 European Society of Medical Oncology (ESMO) virtual
congress.
The Phase III SOLO-1 trial met the primary endpoint of PFS in
June 2018, which formed the basis of approvals in the US, the EU,
Japan, China, and several other countries.2
IMPORTANT SAFETY INFORMATION
CONTRAINDICATIONS
There are no contraindications for LYNPARZA.
WARNINGS AND PRECAUTIONS
Myelodysplastic Syndrome/Acute Myeloid Leukemia
(MDS/AML): Occurred in <1.5% of patients exposed to LYNPARZA
monotherapy, and the majority of events had a fatal outcome. The
duration of therapy in patients who developed secondary MDS/AML
varied from <6 months to >2 years. All of these patients had
previous chemotherapy with platinum agents and/or other
DNA-damaging agents, including radiotherapy, and some also had a
history of more than one primary malignancy or of bone marrow
dysplasia.
Do not start LYNPARZA until patients have recovered from
hematological toxicity caused by previous chemotherapy (≤Grade 1).
Monitor complete blood count for cytopenia at baseline and monthly
thereafter for clinically significant changes during treatment. For
prolonged hematological toxicities, interrupt LYNPARZA and monitor
blood count weekly until recovery.
If the levels have not recovered to Grade 1 or less after 4
weeks, refer the patient to a hematologist for further
investigations, including bone marrow analysis and blood sample for
cytogenetics. Discontinue LYNPARZA if MDS/AML is confirmed.
Pneumonitis: Occurred in <1% of patients exposed to
LYNPARZA, and some cases were fatal. If patients present with new
or worsening respiratory symptoms such as dyspnea, cough, and
fever, or a radiological abnormality occurs, interrupt LYNPARZA
treatment and initiate prompt investigation. Discontinue LYNPARZA
if pneumonitis is confirmed and treat patient appropriately.
Embryo-Fetal Toxicity: Based on its mechanism of action
and findings in animals, LYNPARZA can cause fetal harm. A pregnancy
test is recommended for females of reproductive potential prior to
initiating treatment.
Females
Advise females of reproductive potential of the potential risk
to a fetus and to use effective contraception during treatment and
for 6 months following the last dose.
Males
Advise male patients with female partners of reproductive
potential or who are pregnant to use effective contraception during
treatment and for 3 months following the last dose of LYNPARZA and
to not donate sperm during this time.
Venous Thromboembolic Events: Including pulmonary
embolism, occurred in 7% of patients with metastatic
castration-resistant prostate cancer who received LYNPARZA plus
androgen deprivation therapy (ADT) compared to 3.1% of patients
receiving enzalutamide or abiraterone plus ADT in the PROfound
study. Patients receiving LYNPARZA and ADT had a 6% incidence of
pulmonary embolism compared to 0.8% of patients treated with ADT
plus either enzalutamide or abiraterone. Monitor patients for signs
and symptoms of venous thrombosis and pulmonary embolism, and treat
as medically appropriate, which may include long-term
anticoagulation as clinically indicated.
ADVERSE REACTIONS—First-Line Maintenance BRCAm Advanced
Ovarian Cancer
Most common adverse reactions (Grades 1-4) in ≥10% of patients
in clinical trials of LYNPARZA in the first-line maintenance
setting for SOLO-1 were: nausea (77%), fatigue (67%),
abdominal pain (45%), vomiting (40%), anemia (38%), diarrhea (37%),
constipation (28%), upper respiratory tract
infection/influenza/nasopharyngitis/bronchitis (28%), dysgeusia
(26%), decreased appetite (20%), dizziness (20%), neutropenia
(17%), dyspepsia (17%), dyspnea (15%), leukopenia (13%), UTI (13%),
thrombocytopenia (11%), and stomatitis (11%).
Most common laboratory abnormalities (Grades 1-4) in ≥25% of
patients in clinical trials of LYNPARZA in the first-line
maintenance setting for SOLO-1 were: decrease in
hemoglobin (87%), increase in mean corpuscular volume (87%),
decrease in leukocytes (70%), decrease in lymphocytes (67%),
decrease in absolute neutrophil count (51%), decrease in platelets
(35%), and increase in serum creatinine (34%).
ADVERSE REACTIONS—First-Line Maintenance Advanced Ovarian
Cancer in Combination with Bevacizumab
Most common adverse reactions (Grades 1-4) in ≥10% of patients
treated with LYNPARZA/bevacizumab compared to a ≥5% frequency for
placebo/bevacizumab in the first-line maintenance setting
for PAOLA-1 were: nausea (53%), fatigue (including asthenia)
(53%), anemia (41%), lymphopenia (24%), vomiting (22%) and
leukopenia (18%). In addition, the most common adverse reactions
(≥10%) for patients receiving LYNPARZA/bevacizumab irrespective of
the frequency compared with the placebo/bevacizumab arm were:
diarrhea (18%), neutropenia (18%), urinary tract infection (15%)
and headache (14%).
In addition, venous thromboembolic events occurred more commonly
in patients receiving LYNPARZA/bevacizumab (5%) than in those
receiving placebo/bevacizumab (1.9%).
Most common laboratory abnormalities (Grades 1-4) in ≥25% of
patients for LYNPARZA in combination with bevacizumab in the
first-line maintenance setting for PAOLA-1 were:
decrease in hemoglobin (79%), decrease in lymphocytes (63%),
increase in serum creatinine (61%), decrease in leukocytes (59%),
decrease in absolute neutrophil count (35%) and decrease in
platelets (35%).
ADVERSE REACTIONS—Maintenance Recurrent Ovarian
Cancer
Most common adverse reactions (Grades 1-4) in ≥20% of patients
in clinical trials of LYNPARZA in the maintenance setting
for SOLO-2 were: nausea (76%), fatigue (including asthenia)
(66%), anemia (44%), vomiting (37%), nasopharyngitis/upper
respiratory tract infection (URI)/influenza (36%), diarrhea (33%),
arthralgia/myalgia (30%), dysgeusia (27%), headache (26%),
decreased appetite (22%), and stomatitis (20%).
Study 19: nausea (71%), fatigue (including asthenia)
(63%), vomiting (35%), diarrhea (28%), anemia (23%), respiratory
tract infection (22%), constipation (22%), headache (21%),
decreased appetite (21%) and dyspepsia (20%).
Most common laboratory abnormalities (Grades 1-4) in ≥25% of
patients in clinical trials of LYNPARZA in the maintenance
setting (SOLO-2/Study 19) were: increase in mean corpuscular
volume (89%/82%), decrease in hemoglobin (83%/82%), decrease in
leukocytes (69%/58%), decrease in lymphocytes (67%/52%), decrease
in absolute neutrophil count (51%/47%), increase in serum
creatinine (44%/45%), and decrease in platelets (42%/36%).
ADVERSE REACTIONS—Advanced gBRCAm Ovarian Cancer
Most common adverse reactions (Grades 1-4) in ≥20% of patients
in clinical trials of LYNPARZA for advanced gBRCAm ovarian
cancer after 3 or more lines of chemotherapy (pooled from 6
studies) were: fatigue/asthenia (66%), nausea (64%), vomiting
(43%), anemia (34%), diarrhea (31%), nasopharyngitis/upper
respiratory tract infection (URI) (26%), dyspepsia (25%), myalgia
(22%), decreased appetite (22%), and arthralgia/musculoskeletal
pain (21%).
Most common laboratory abnormalities (Grades 1-4) in ≥25% of
patients in clinical trials of LYNPARZA for advanced gBRCAm
ovarian cancer (pooled from 6 studies) were: decrease in
hemoglobin (90%), mean corpuscular volume elevation (57%), decrease
in lymphocytes (56%), increase in serum creatinine (30%), decrease
in platelets (30%), and decrease in absolute neutrophil count
(25%).
ADVERSE REACTIONS—gBRCAm, HER2-Negative Metastatic Breast
Cancer
Most common adverse reactions (Grades 1-4) in ≥20% of patients
in OlympiAD were: nausea (58%), anemia (40%), fatigue
(including asthenia) (37%), vomiting (30%), neutropenia (27%),
respiratory tract infection (27%), leukopenia (25%), diarrhea
(21%), and headache (20%).
Most common laboratory abnormalities (Grades 1-4) in ≥25% of
patients in OlympiAD were: decrease in hemoglobin (82%),
decrease in lymphocytes (73%), decrease in leukocytes (71%),
increase in mean corpuscular volume (71%), decrease in absolute
neutrophil count (46%), and decrease in platelets (33%).
ADVERSE REACTIONS—First-Line Maintenance gBRCAm Metastatic
Pancreatic Adenocarcinoma
Most common adverse reactions (Grades 1-4) in ≥10% of patients
in clinical trials of LYNPARZA in the first-line maintenance
setting for POLO were: fatigue (60%), nausea (45%),
abdominal pain (34%), diarrhea (29%), anemia (27%), decreased
appetite (25%), constipation (23%), vomiting (20%), back pain
(19%), arthralgia (15%), rash (15%), thrombocytopenia (14%),
dyspnea (13%), neutropenia (12%), nasopharyngitis (12%), dysgeusia
(11%), and stomatitis (10%).
Most common laboratory abnormalities (Grades 1-4) in ≥25% of
patients in clinical trials of LYNPARZA in the first-line
maintenance setting for POLO were: increase in serum
creatinine (99%), decrease in hemoglobin (86%), increase in mean
corpuscular volume (71%), decrease in lymphocytes (61%), decrease
in platelets (56%), decrease in leukocytes (50%), and decrease in
absolute neutrophil count (25%).
ADVERSE REACTIONS—HRR Gene-mutated Metastatic
Castration-Resistant Prostate Cancer
Most common adverse reactions (Grades 1-4) in ≥10% of patients
in clinical trials of LYNPARZA for PROfound were: anemia
(46%), fatigue (including asthenia) (41%), nausea (41%), decreased
appetite (30%), diarrhea (21%), vomiting (18%), thrombocytopenia
(12%), cough (11%), and dyspnea (10%).
Most common laboratory abnormalities (Grades 1-4) in ≥25% of
patients in clinical trials of LYNPARZA for PROfound were:
decrease in hemoglobin (98%), decrease in lymphocytes (62%),
decrease in leukocytes (53%), and decrease in absolute neutrophil
count (34%).
DRUG INTERACTIONS
Anticancer Agents: Clinical studies of LYNPARZA in
combination with other myelosuppressive anticancer agents,
including DNA-damaging agents, indicate a potentiation and
prolongation of myelosuppressive toxicity.
CYP3A Inhibitors: Avoid concomitant use of strong or
moderate CYP3A inhibitors. If a strong or moderate CYP3A inhibitor
must be co-administered, reduce the dose of LYNPARZA. Advise
patients to avoid grapefruit, grapefruit juice, Seville oranges,
and Seville orange juice during LYNPARZA treatment.
CYP3A Inducers: Avoid concomitant use of strong or
moderate CYP3A inducers when using LYNPARZA. If a moderate inducer
cannot be avoided, there is a potential for decreased efficacy of
LYNPARZA.
USE IN SPECIFIC POPULATIONS
Lactation: No data are available regarding the presence
of olaparib in human milk, its effects on the breastfed infant or
on milk production. Because of the potential for serious adverse
reactions in the breastfed infant, advise a lactating woman not to
breastfeed during treatment with LYNPARZA and for 1 month after
receiving the final dose.
Pediatric Use: The safety and efficacy of LYNPARZA have
not been established in pediatric patients.
Hepatic Impairment: No adjustment to the starting dose is
required in patients with mild or moderate hepatic impairment
(Child-Pugh classification A and B). There are no data in patients
with severe hepatic impairment (Child-Pugh classification C).
Renal Impairment: No dosage modification is recommended
in patients with mild renal impairment (CLcr 51-80 mL/min estimated
by Cockcroft-Gault). In patients with moderate renal impairment
(CLcr 31-50 mL/min), reduce the dose of LYNPARZA to 200 mg twice
daily. There are no data in patients with severe renal impairment
or end-stage renal disease (CLcr ≤30 mL/min).
INDICATIONS
LYNPARZA is a poly (ADP-ribose) polymerase (PARP) inhibitor
indicated:
First-Line Maintenance BRCAm Advanced Ovarian Cancer
For the maintenance treatment of adult patients with deleterious
or suspected deleterious germline or somatic BRCA-mutated (gBRCAm
or sBRCAm) advanced epithelial ovarian, fallopian tube, or primary
peritoneal cancer who are in complete or partial response to
first-line platinum-based chemotherapy. Select patients for therapy
based on an FDA-approved companion diagnostic for LYNPARZA.
First-Line Maintenance HRD Positive Advanced Ovarian Cancer
in Combination with Bevacizumab
In combination with bevacizumab for the maintenance treatment of
adult patients with advanced epithelial ovarian, fallopian tube or
primary peritoneal cancer who are in complete or partial response
to first-line platinum-based chemotherapy and whose cancer is
associated with homologous recombination deficiency (HRD) positive
status defined by either:
- a deleterious or suspected deleterious BRCA mutation,
and/or
- genomic instability
Select patients for therapy based on an FDA-approved companion
diagnostic for LYNPARZA.
Maintenance Recurrent Ovarian Cancer
For the maintenance treatment of adult patients with recurrent
epithelial ovarian, fallopian tube, or primary peritoneal cancer,
who are in complete or partial response to platinum-based
chemotherapy.
Advanced gBRCAm Ovarian Cancer
For the treatment of adult patients with deleterious or
suspected deleterious germline BRCA-mutated (gBRCAm) advanced
ovarian cancer who have been treated with 3 or more prior lines of
chemotherapy. Select patients for therapy based on an FDA-approved
companion diagnostic for LYNPARZA.
gBRCAm, HER2-Negative Metastatic Breast Cancer
For the treatment of adult patients with deleterious or
suspected deleterious gBRCAm, human epidermal growth factor
receptor 2 (HER2)-negative metastatic breast cancer who have been
treated with chemotherapy in the neoadjuvant, adjuvant, or
metastatic setting. Patients with hormone receptor (HR)-positive
breast cancer should have been treated with a prior endocrine
therapy or be considered inappropriate for endocrine therapy.
Select patients for therapy based on an FDA-approved companion
diagnostic for LYNPARZA.
First-Line Maintenance gBRCAm Metastatic Pancreatic
Cancer
For the maintenance treatment of adult patients with deleterious
or suspected deleterious gBRCAm metastatic pancreatic
adenocarcinoma whose disease has not progressed on at least 16
weeks of a first-line platinum-based chemotherapy regimen. Select
patients for therapy based on an FDA-approved companion diagnostic
for LYNPARZA.
HRR Gene-mutated Metastatic Castration-Resistant Prostate
Cancer
For the treatment of adult patients with deleterious or
suspected deleterious germline or somatic homologous recombination
repair (HRR) gene-mutated metastatic castration-resistant prostate
cancer (mCRPC) who have progressed following prior treatment with
enzalutamide or abiraterone. Select patients for therapy based on
an FDA-approved companion diagnostic for LYNPARZA.
Please click here for complete Prescribing Information,
including Patient Information (Medication Guide).
About Ovarian Cancer
Approximately 21,750 women in the United States will be
diagnosed with ovarian cancer (including ovarian, fallopian tube
and primary peritoneal cancers) in 2020. Among women in the United
States, it is the fifth leading cause of cancer death.1
The risk of developing ovarian cancer is increased in women with
specific inherited genetic abnormalities, including BRCA
mutations.3
About SOLO-1
SOLO-1 was a Phase III randomized, double-blinded,
placebo-controlled, multi-center trial to evaluate the efficacy and
safety of LYNPARZA tablets (300 mg twice daily) as a maintenance
monotherapy compared with placebo in patients with newly diagnosed
BRCAm advanced ovarian cancer following first-line platinum-based
chemotherapy. The trial randomized 391 patients with a deleterious
or suspected deleterious germline or somatic BRCA1 or BRCA2
mutation who were in clinical complete or partial response
following platinum-based chemotherapy.
Patients were randomized (2:1) to receive LYNPARZA or placebo
for up to two years or until disease progression. Patients who had
a partial response at two years were permitted to stay on therapy
at the investigator’s discretion.4 The primary endpoint was PFS and
key secondary endpoints included time to second disease progression
or death, time to first subsequent treatment and overall
survival.2
About LYNPARZA
LYNPARZA® (olaparib) is a first-in-class PARP inhibitor and the
first targeted treatment to block DNA damage response (DDR) in
cells/tumors harboring a deficiency in homologous recombination
repair, such as mutations in BRCA1 and/or BRCA2.4,5,6 Inhibition of
PARP with LYNPARZA leads to the trapping of PARP bound to DNA
single-strand breaks, stalling of replication forks, their collapse
and the generation of DNA double-strand breaks and cancer cell
death.7 LYNPARZA is being tested in a range of PARP-dependent tumor
types with defects and dependencies in the DDR pathway.
LYNPARZA is currently approved in a number of countries,
including those in the US, for the maintenance treatment of
platinum-sensitive relapsed ovarian cancer. It is approved in the
US, the EU, Japan, China, and several other countries as 1st-line
maintenance treatment of BRCA-mutated advanced ovarian cancer
following response to platinum-based chemotherapy. It is also
approved in the US as a 1st-line maintenance treatment with
bevacizumab for patients with homologous recombination deficiency
(HRD)-positive advanced ovarian cancer. LYNPARZA is approved in the
US, Japan, and a number of other countries for the treatment of
germline BRCA-mutated, HER2-negative, metastatic breast cancer,
previously treated with chemotherapy; in the EU, this includes
locally advanced breast cancer. It is also approved in the US and
several other countries for the treatment of germline BRCA-mutated
metastatic pancreatic cancer. LYNPARZA is approved in the US for
HRR gene-mutated metastatic castration-resistant prostate cancer.
Regulatory reviews are underway in several countries for ovarian,
breast, pancreatic and prostate cancers.
LYNPARZA, which is being jointly developed and commercialized by
AstraZeneca and Merck, has been used to treat over 30,000 patients
worldwide. LYNPARZA has the broadest and most advanced clinical
trial development program of any PARP inhibitor, and AstraZeneca
and Merck are working together to understand how it may affect
multiple PARP-dependent tumors as a monotherapy and in combination
across multiple cancer types. LYNPARZA is the foundation of
AstraZeneca’s industry-leading portfolio of potential new medicines
targeting DDR mechanisms in cancer cells.
About the AstraZeneca and Merck Strategic Oncology
Collaboration
In July 2017, AstraZeneca and Merck & Co., Inc., Kenilworth,
NJ, US, known as MSD outside the United States and Canada,
announced a global strategic oncology collaboration to co-develop
and co-commercialize LYNPARZA, the world’s first PARP inhibitor,
and KOSELUGO (selumetinib), a MEK inhibitor, for multiple cancer
types. Working together, the companies will develop LYNPARZA and
other compounds in combination with other potential new medicines
and as monotherapies. Independently, the companies will develop
LYNPARZA and KOSELUGO in combination with their respective PD-L1
and PD-1 medicines.
About AstraZeneca in Oncology
AstraZeneca has a deep-rooted heritage in oncology and offers a
quickly growing portfolio of new medicines that has the potential
to transform patients’ lives and the Company’s future. With seven
new medicines launched between 2014 and 2020, and a broad pipeline
of small molecules and biologics in development, the Company is
committed to advance oncology as a key growth driver for
AstraZeneca focused on lung, ovarian, breast and blood cancers.
By harnessing the power of four scientific platforms –
Immuno-Oncology, Tumor Drivers and Resistance, DNA Damage Response
and Antibody Drug Conjugates – and by championing the development
of personalized combinations, AstraZeneca has the vision to
redefine cancer treatment and, one day, eliminate cancer as a cause
of death.
About AstraZeneca
AstraZeneca is a global, science-led biopharmaceutical company
that focuses on the discovery, development and commercialization of
prescription medicines, primarily for the treatment of diseases in
three therapy areas - Oncology, Cardiovascular, Renal &
Metabolism and Respiratory & Immunology. AstraZeneca operates
in over 100 countries and its innovative medicines are used by
millions of patients worldwide. Please visit www.astrazeneca-us.com
and follow the Company on Twitter @AstraZenecaUS.
REFERENCES
- American Cancer Society. About Ovarian Cancer. Available
Online. Accessed September 2020.
- US National Institutes of Health. Olaparib Maintenance
Monotherapy in Patients with BRCA Mutated Ovarian Cancer Following
First-Line Platinum Based Chemotherapy. Available Online. Accessed
October 2020.
- National Cancer Institute. BRCA1 and BRCA2: cancer risk and
genetic testing. Available Online. Accessed September 2020.
- LYNPARZA® (olaparib) [prescribing information]. Wilmington, DE:
AstraZeneca Pharmaceuticals LP; 2020.
- O’Connor M. Targeting the DNA damage response in cancer. Mol
Cell. 2015; Accessed September 2020.
- Tutt AN, Lord CJ, McCabe N. Exploiting the DNA repair defect in
BRCA mutant cells in the design of new therapeutic strategies for
cancer. Cold Spring Harb Symp Quant Biol. 2005;70:139-148.
- Brown JS et al. Targeting DNA Repair in Cancer: Beyond PARP
Inhibitors. Cancer Discov. 2017;(1):20-37.
US-45203 Last Updated 9/20
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