Niraparib maintenance (HRD+ recurrent platinum-sensitive ovarian, NOVA / PRIMA)

Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.

Knowledge-base record for audit. Provisional clinical content: this is not a prescription. An oncologist must verify original sources, applicability and review status. Full rules and constraints are in the YAML.

Source YAML: complete record

Components	`DRUG-NIRAPARIB`

ID	`REG-NIRAPARIB-MAINT-OVARIAN`
Type	Regimen
Status	reviewed 2026-04-27 \| pending_clinical_signoff
Diseases	None declared
Sources	`SRC-ESMO-OVARIAN-2024` `SRC-NCCN-OVARIAN-2025` `SRC-NOVA-MIRZA-2016` `SRC-PRIMA-GONZALEZ-MARTIN-2019`

Notes

NOVA (2L+ recurrent platinum-sensitive maintenance): gBRCA mPFS 21.0 vs 5.5 mo; non-gBRCA HRD+ 12.9 vs 3.8 mo; non-gBRCA all 9.3 vs 3.9 mo. Individualized starting-dose rule (Berek 2018) reduces thrombocytopenia without compromising efficacy. CBC weekly first month, then monthly. Long-term MDS/AML risk warrants pre-treatment counseling.

Used By

Handbook Chapters

HB-OVARIAN-MAINTENANCE-1L - Advanced ovarian cancer: HRD/BRCA first-line maintenance reasoning

Handbook Questions

HQ-OVARIAN-MAINTENANCE-1L-002 - HQ-OVARIAN-MAINTENANCE-1L-002

Indication

IND-OVARIAN-MAINT-PARPI-HRD-NIRAPARIB - IND-OVARIAN-MAINT-PARPI-HRD-NIRAPARIB

Regimen

REG-RUCAPARIB-MAINT-OVARIAN - Rucaparib maintenance (recurrent platinum-sensitive ovarian, ARIEL3)