Niraparib (Zejula®), a poly (ADP-ribose) polymerase (PARP) inhibitor, is 
approved for the maintenance treatment of recurrent, epithelial ovarian, 
fallopian tube, or primary peritoneal cancer in patients who are in complete or 
partial response to platinum-based chemotherapy. Approval was based on the 
results of the randomized, double-blind, placebo-controlled phase III NOVA 
trial. In NOVA, niraparib significantly prolonged progression-free survival 
(primary endpoint), chemotherapy-free interval and time to first subsequent 
therapy compared with placebo in patients with recurrent, platinum-sensitive, 
high grade serous ovarian, fallopian tube or primary peritoneal cancer. The 
beneficial effects of niraparib were consistent regardless of BRCA mutation or 
homologous recombination deficiency (HRD) status. Niraparib had a manageable 
tolerability profile, with the majority of grade 3 or 4 adverse events being 
haematologic abnormalities (e.g. thrombocytopenia, anaemia, neutropenia). 
Adverse events were generally well managed with dose interruption or 
modification of niraparib. Current evidence suggests that niraparib is an 
effective new option with a manageable tolerability profile for the maintenance 
treatment of recurrent, platinum-sensitive epithelial ovarian, fallopian tube, 
or primary peritoneal cancer in adults, with or without BRCA1/2 mutation or HRD.