FDA Approval Summary: Rucaparib for the Treatment of Patients with Deleterious <i>BRCA</i> Mutation–Associated Advanced Ovarian Cancer

On December 19, 2016, the FDA granted accelerated approval to rucaparib (RUBRACA; Clovis Oncology, Inc.) for the treatment of patients with deleterious <i>BRCA</i> mutation (germline and/or somatic)-associated advanced ovarian cancer who have been treated with two or more chemotherapies. The FDA also approved the FoundationFocus CDx <i>_BRCA</i> test (Foundation Medicine, Inc.), the first next-generation sequencing-based companion diagnostic, for identifying patients with advanced ovarian cancer eligible for treatment with rucaparib based on detection of deleterious <i>BRCA1</i> and/or <i>BRCA2</i> mutations in tumor tissue. Rucaparib's approval was based primarily on efficacy data from 106 patients with <i>BRCA</i> mutation-associated ovarian cancer who had prior treatment with two or more chemotherapies and safety data from 377 patients with ovarian cancer treated with rucaparib 600 mg orally twice daily on two open-label, single-arm trials. Investigator-assessed objective response rate was 54% [57/106; 95% confidence interval (CI), 44-64], and median duration of response was 9.2 months (95% CI, 6.6-11.7). The approved companion diagnostic verified tumor <i>BRCA</i> mutation status retrospectively in 96% (64/67) of patients. Common adverse reactions (≥20%) to rucaparib were nausea, fatigue, vomiting, anemia, abdominal pain, dysgeusia, constipation, decreased appetite, diarrhea, thrombocytopenia, and dyspnea. This article summarizes the FDA review and data supporting rucaparib's accelerated approval. <i>Clin Cancer Res; 23(23); 7165-70. ©2017 AACR</i><i>See related commentary by Kohn et al., p. 7155</i>.