Olaparib Plus Paclitaxel and Carboplatin May Be Safe, Effective for Platinum-Sensitive, Recurrent Ovarian Cancer

the Cancer Therapy Advisor take:

According to a new study published in the journal The Lancet Oncology, olaparib plus paclitaxel and carboplatin followed by olaparib monotherapy significantly improved progression-free survival compared with paclitaxel plus carboplatin alone for the treatment of patients with platinum-sensitive, recurrent, high-grade serous ovarian cancer.

For this international, multicenter, open-label, phase 2 study, 162 patients were randomly assigned to receive either olaparib 200mg orally twice daily on days 1-10 of each 21-day cycle plus paclitaxel 175mg/m2 intravenously on day 1 and carboplatin AUC 4 intravenously on day 1, followed by olaparib monotherapy 400mg orally twice daily until disease progression, or paclitaxel 175mg/m2 intravenously and carboplatin AUC 6 intravenously on day 1 with no maintenance phase.

Results showed that progression-free survival was significantly improved in the chemotherapy plus olaparib group (median 12.2 months; 95% CI: 9.7 - 15.0) compared with the chemotherapy alone group (median 9.6 months; 95% CI: 9.1 - 9.7; P = 0.0012).

Patients with BRCA gene mutations in the olaparib arm had particularly longer progression-free survival than those in the chemotherapy alone arm (HR = 0.21 [0.08 - 0.55]; P = 0.0015). Adverse effects more common in the olaparib arm were: alopecia, diarrhea, dyspepsia, headache, nausea, neutropenia, and peripheral neuropathy. Serious adverse effects were more common in those that received chemotherapy alone compared with olaparib plus chemotherapy.

The findings suggest that olaparib prolongs progression-free survival when added to paclitaxel and carboplatin for the treatment of patients with recurrent, high-grade serious ovarian cancer, especially those with BRCA gene mutations, and is well-tolerated.