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Olaparib: A Review as First-Line Maintenance Therapy in Advanced Ovarian Cancer

  • Adis Drug Evaluation
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Abstract

Olaparib (Lynparza®) is a poly (adenosine diphosphate-ribose) polymerase (PARP) inhibitor approved for first-line maintenance treatment in adults with advanced ovarian cancer who are in complete or partial response to first-line, platinum-based chemotherapy. Originally approved as monotherapy, olaparib is also approved to be administered in combination with bevacizumab in patients whose cancer is associated with homologous recombination deficiency (HRD), defined by either a BRCA1/2 mutation and/or genomic instability. In phase III trials, olaparib monotherapy significantly improved progression-free survival (PFS) relative to placebo (SOLO-1), as did olaparib plus bevacizumab relative to placebo plus bevacizumab (PAOLA-1), in patients with advanced ovarian cancer who had responded to platinum-based chemotherapy. In PAOLA-1, improvements in PFS with olaparib plus bevacizumab were not seen in patients with HRD-negative tumours relative to placebo plus bevacizumab. Both olaparib monotherapy and olaparib in combination with bevacizumab had generally manageable tolerability profiles. Olaparib, alone or in combination with bevacizumab, is a useful option for the first-line maintenance treatment of adults with HRD-positive, advanced epithelial ovarian, fallopian tube or primary peritoneal cancer who are in complete or partial response to first-line, platinum-based chemotherapy.

Plain Language Summary

Oral olaparib (Lynparza®) was originally approved as monotherapy for the first-line maintenance treatment of adults with advanced high-grade epithelial ovarian, fallopian tube or primary peritoneal cancer who responded to first-line, platinum-based chemotherapy. Olaparib is also approved to be used in combination with bevacizumab in patients whose cancer is associated with homologous recombination deficiency (HRD), which is characterized by BRCA1/2 mutations or genomic instability. Olaparib reduced the risk of disease progression or death in patients who had received platinum-based chemotherapy without bevacizumab (when olaparib was given as monotherapy) and with bevacizumab (when olaparib was given with bevacizumab). However, this reduction was not seen in patients with HRD-negative tumours who were treated with olaparib plus bevacizumab compared with placebo plus bevacizumab. Both olaparib monotherapy and olaparib in combination with bevacizumab had generally manageable tolerability profiles. Olaparib, alone or in combination with bevacizumab, is a useful option for the first-line maintenance treatment of adults with HRD-positive, advanced ovarian cancer who responded to first-line, platinum-based chemotherapy.

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Acknowledgements

During the peer review process the manufacturer of olaparib was also offered an opportunity to review this article. Changes resulting from comments received were made on the basis of scientific and editorial merit.

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    Julia Paik

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  1. Julia Paik
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Correspondence to Julia Paik.

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The preparation of this review was not supported by any external funding.

Authorship and conflict of interest

Julia Paik is a salaried employee of Adis International Ltd/Springer Nature, and declares no relevant conflicts of interest. All authors contributed to the review and are responsible for the article content.

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Not applicable.

Additional information

The manuscript was reviewed by: S. Nishio, Obstetrics and Gynecology, Kurume University School of Medicines, Fukuoka, Japan; I. Ray-Coquard, Department of Medical Oncology, Centre Léon Bérard, Lyon, France; P. Ghatage, Division of Gynecologic Oncology, Tom Baker Cancer Centre, Calgary, Canada.

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Paik, J. Olaparib: A Review as First-Line Maintenance Therapy in Advanced Ovarian Cancer. Targ Oncol 16, 847–856 (2021). https://doi.org/10.1007/s11523-021-00842-1

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