First evidence of olaparib maintenance therapy in patients with newly diagnosed homologous recombination deficient positive/BRCA wild-type ovarian cancer: real-world multicenter study

Front Med. 2024 Dec;18(6):1026-1034. doi: 10.1007/s11684-024-1083-5. Epub 2024 Nov 6.

Abstract

Although olaparib has demonstrated substantial clinical benefits as maintenance therapy in BRCA mutation-carrying women with newly diagnosed advanced ovarian cancer, its effectiveness in patients without BRCA mutations remains poorly investigated. This study aims to provide the first evidence on the efficacy of mono-olaparib maintenance therapy in such context. Using real-world data from 11 high-volume tertiary care centers in China, a retrospective cohort study was conducted to assess the efficacy and safety of olaparib as first-line maintenance therapy in patients with BRCA wild-type ovarian cancer. The primary objective was 1-year progression-free survival rate. Safety was also evaluated. Fifty patients with a median age of 54 years were included, and all of them tested negative for BRCA mutations but positive for homologous recombination deficiency (HRD). The 1-year PFS rate was 75.2% (95% CI, 63.4 to 89.2), and the median PFS was 21.0 months (95% CI, 13.8 to 28.2). All the patients received olaparib at a starting dose of 300 mg twice daily, and none experienced serious adverse events (AEs). Eight (16%) patients had dose adjustment, but none discontinued olaparib treatment due to AEs. We provide the first evidence that mono-olaparib could be a safe and effective maintenance treatment option for patients newly diagnosed with HRD-positive/BRCA wild-type ovarian cancer.

Keywords: adverse events; maintenance therapy; olaparib; ovarian cancer; progression-free survival.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Agents / adverse effects
  • Antineoplastic Agents / therapeutic use
  • BRCA1 Protein / genetics
  • BRCA2 Protein / genetics
  • China
  • Female
  • Humans
  • Maintenance Chemotherapy
  • Middle Aged
  • Ovarian Neoplasms* / drug therapy
  • Ovarian Neoplasms* / genetics
  • Phthalazines* / administration & dosage
  • Phthalazines* / adverse effects
  • Phthalazines* / therapeutic use
  • Piperazines* / administration & dosage
  • Piperazines* / therapeutic use
  • Poly(ADP-ribose) Polymerase Inhibitors* / administration & dosage
  • Poly(ADP-ribose) Polymerase Inhibitors* / adverse effects
  • Poly(ADP-ribose) Polymerase Inhibitors* / therapeutic use
  • Progression-Free Survival
  • Retrospective Studies

Substances

  • olaparib
  • Phthalazines
  • Piperazines
  • Poly(ADP-ribose) Polymerase Inhibitors
  • BRCA2 Protein
  • Antineoplastic Agents
  • BRCA1 Protein