# PARP inhibitor + bevacizumab maintenance (HRD-positive)

Source: https://onco.cc/pairings/parp-plus-bevacizumab/  
OnCo record `parp-plus-bevacizumab` (Pairing). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

In tumours with faulty DNA repair, adding olaparib to bevacizumab maintenance roughly doubled progression-free time and improved survival.

## Summary

In newly diagnosed advanced ovarian cancer with homologous recombination deficiency, adding the PARP inhibitor olaparib to bevacizumab maintenance is a combination pairing that markedly prolonged progression-free time and improved overall survival in the phase 3 PAOLA-1 / ENGOT-ov25 trial, with no benefit seen in HRD-negative tumours. The mechanistic rationale is that anti-angiogenic hypoxia may push tumour cells into HRD-like states and greater dependence on PARP, and the two agents have non-overlapping toxicity. The combination was approved in 2020. Because the benefit was confined to the HRD-positive subgroup, the pairing made HRD testing a routine first-line decision in ovarian cancer.

## Fields

- Kind: Pairing
- Last checked: 2026-09-07
- Pairs: Olaparib + Bevacizumab
- Type: combination
- Rationale: Anti-angiogenic hypoxia may increase HRD-like states and PARP dependence; the two agents have non-overlapping toxicity.
- Evidence: Phase 3 with OS benefit in HRD-positive subgroup.

## Sources

- ClinicalTrials.gov NCT02477644: PAOLA-1 / ENGOT-ov25: https://clinicaltrials.gov/study/NCT02477644

## Connected records

- cancers: [Ovarian cancer](https://onco.cc/cancers/ovarian/), [Platinum-sensitive ovarian cancer](https://onco.cc/cancers/platinum-sensitive-ovarian-cancer/)
- targets: [PARP](https://onco.cc/targets/parp/), [VEGF / VEGFR](https://onco.cc/targets/vegf/)
- terms: [Homologous recombination deficiency (HRD)](https://onco.cc/terms/hrd/)
- trials: [PAOLA-1 / ENGOT-ov25](https://onco.cc/trials/paola-1/)
- drugs: [Bevacizumab](https://onco.cc/drugs/bevacizumab/), [Olaparib](https://onco.cc/drugs/olaparib/)

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