Olaparib monotherapy in patients with advanced cancer and a germline BRCA1/2 mutation
- PMID: 25366685
- PMCID: PMC6057749
- DOI: 10.1200/JCO.2014.56.2728
Olaparib monotherapy in patients with advanced cancer and a germline BRCA1/2 mutation
Abstract
Purpose: Olaparib is an oral poly (ADP-ribose) polymerase inhibitor with activity in germline BRCA1 and BRCA2 (BRCA1/2) -associated breast and ovarian cancers. We evaluated the efficacy and safety of olaparib in a spectrum of BRCA1/2-associated cancers.
Patients and methods: This multicenter phase II study enrolled individuals with a germline BRCA1/2 mutation and recurrent cancer. Eligibility included ovarian cancer resistant to prior platinum; breast cancer with ≥ three chemotherapy regimens for metastatic disease; pancreatic cancer with prior gemcitabine treatment; or prostate cancer with progression on hormonal and one systemic therapy. Olaparib was administered at 400 mg twice per day. The primary efficacy end point was tumor response rate.
Results: A total of 298 patients received treatment and were evaluable. The tumor response rate was 26.2% (78 of 298; 95% CI, 21.3 to 31.6) overall and 31.1% (60 of 193; 95% CI, 24.6 to 38.1), 12.9% (eight of 62; 95% CI, 5.7 to 23.9), 21.7% (five of 23; 95% CI, 7.5 to 43.7), and 50.0% (four of eight; 95% CI, 15.7 to 84.3) in ovarian, breast, pancreatic, and prostate cancers, respectively. Stable disease ≥ 8 weeks was observed in 42% of patients (95% CI, 36.0 to 47.4), including 40% (95% CI, 33.4 to 47.7), 47% (95% CI, 34.0 to 59.9), 35% (95% CI, 16.4 to 57.3), and 25% (95% CI, 3.2 to 65.1) of those with ovarian, breast, pancreatic, or prostate cancer, respectively. The most common adverse events (AEs) were fatigue, nausea, and vomiting. Grade ≥ 3 AEs were reported for 54% of patients; anemia was the most common (17%).
Conclusion: Responses to olaparib were observed across different tumor types associated with germline BRCA1/2 mutations. Olaparib warrants further investigation in confirmatory studies.
© 2014 by American Society of Clinical Oncology.
Conflict of interest statement
Authors' disclosures of potential conflicts of interest and author contributions are found at the end of this article.
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Comment in
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The long and winding road.J Clin Oncol. 2015 Jan 20;33(3):229-31. doi: 10.1200/JCO.2014.59.2311. Epub 2014 Dec 1. J Clin Oncol. 2015. PMID: 25452438 No abstract available.
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To BRCA or Not to PALB.J Clin Oncol. 2015 Aug 10;33(23):2581-2. doi: 10.1200/JCO.2014.60.0585. Epub 2015 Jun 29. J Clin Oncol. 2015. PMID: 26124473 No abstract available.
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Germline BRCA1/2 Mutations: Are They Good Enough to Determine Who Will Respond to Poly(ADP-Ribose) Polymerase Inhibitor Therapy in Advanced Cancer?J Clin Oncol. 2015 Aug 10;33(23):2582. doi: 10.1200/JCO.2015.61.0576. Epub 2015 Jun 29. J Clin Oncol. 2015. PMID: 26124479 No abstract available.
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Reply to M.G. McNamara et al and M.S. Copur et al.J Clin Oncol. 2015 Aug 10;33(23):2583-4. doi: 10.1200/JCO.2015.61.8298. Epub 2015 Jun 29. J Clin Oncol. 2015. PMID: 26124483 No abstract available.
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[POLO study].Bull Cancer. 2019 Sep;106(9):717-718. doi: 10.1016/j.bulcan.2019.07.003. Epub 2019 Aug 13. Bull Cancer. 2019. PMID: 31420091 French. No abstract available.
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