Olaparib shows 1-year survival benefit in recurrent ovarian cancer, BRCA mutations
Overall survival results from SOLO-2 showed patients with recurrent ovarian cancer and germline BRCA mutations added a year of life when treated with olaparib only, Ursula A. Matulonis, MD, of Dana Farber Cancer Institute, told Healio.
The results, presented during the ASCO2020 Virtual Scientific Program, were the final results from the landmark study that supported FDA approval of the PARP inhibitor, olaparib (Lynparza, AstraZeneca, Merck), Matulonis said.
“Olaparib as maintenance treatment post platinum-based chemotherapy in BRCA mutation carriers offers ... 12.9-month overall survival improvement compared to placebo and that overall survival improvement holds up even after a crossover analysis,” she said.
That was shown despite nearly 40% of patients who received placebo eventually going on a PARP inhibitor. Matulonis said when that switch was accounted for, survival improved for almost 16 months for patients who receive PARP inhibitor vs. placebo, “so certainly strong indications for an overall survival benefit.”
Matulonis warned that while OS was extended, there was also an uptick in toxicities in the form of acute myeloid leukemia and myelodysplastic syndrome (MDS).
“One of the serious but rare toxicities of PARP inhibitors especially in germline BRCA mutation carriers is the risk of AML and MDS,” she said. “At first glance when this manuscript and trial was first presented, the risk of AML and MDS was about 2% in patients receiving olaparib. However, that actually goes up to 8% now with longer follow-up. ... It’s important to remember that when patients are receiving these drugs, they have to be monitored for dropping blood counts. If that’s starting to happen, you have to hold the PARP inhibitor and search for AML or MDS.”