Unprecedented improvement of ovarian cancer survival in BRCA-positive patients

Posted in BRCA; Posted 6 years ago by Andreas Obermair

The drug olaparib delays the recurrence of advanced ovarian cancer in woman who carry the BRCA gene.

I recently attended the 2018 European Society for Medical Oncology (ESMO) Congress in Germany. I attended a talk on the Phase 3 SOLO-1 trial which used Olaparib tablets to treat patients as a maintenance treatment with newly diagnosed ovarian cancer.

Olaparib, also known as Lynparza, is a targeted cancer drug and one of a class of PARP inhibitor drugs, because it blocks the PARP molecule within cancer cells. By helping to stop PARP from working, Olaparib can limit a cancer cell’s ability to repair DNA damage, and this leads to cancer cell death. Olaparib is already used to treat women whose advanced ovarian cancer has recurred, but not previously used in first time ovarian cancer patients.

In the SOLO-1 trial, 260 women with the BRCA gene mutation were given olaparib and 130 were given a placebo. Both groups underwent surgery and chemotherapy after their cancer was detected. This study was to determine if Olaparib could achieve a significant improvement in progression-free survival following first line platinum-based chemotherapy in BRCA positive patients with first time ovarian cancer.

The trial findings showed an unprecedented survival benefit using Olaparib as maintenance treatment. Time to progression was prolonged by a whopping 3 years in the Olaparib drug group. This is game changing for patients and doctors. Instead of the drug being limited to those whose cancer has returned, doctors could soon approve its use for first-time ovarian cancer patients, pending government approval.

Olaparib reduced the risk of disease progression or death by 70% compared with placebo, and at 41 months of follow-up, median progression-free survival was not reached compared to 13.8 months for patients treated with placebo.

Of those receiving Olaparib, 60% remained progression-free at 36 months compared with 27% of women in the placebo arm.

This study was on BRCA-positive patients only. That means that we now need to test all women with advanced ovarian cancer to identify those who will benefit from Olaparib.  Every ovarian cancer patient should now be tested – regardless of age and family history. BRCA testing should become standard management now in gynaecological cancer patients.

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