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Maintenance Olaparib Improves PFS in BRCA-Mutated, Platinum-Sensitive Ovarian Cancer

July 29, 2020

In this video excerpt from Oncology Learning Network, Richard Penson, MD, MRCP, discusses the results from the SOLO2 study which showed that maintenance therapy with the PARP inhibitor led to a statistically significant improvement in median PFS versus placebo in patients with platinum-sensitive relapsed ovarian cancer and a BRCA mutation.

These results were presented at the virtual 2020 ASCO Annual Meeting.

View the full video on Oncology Learning Nework.

Transcript

I think my excitement was really about a milestone presentation in terms of SOLO‑2, the randomized participants with platinum‑sensitive recurrent ovarian cancer who'd had a response to platinum‑based combination therapy, and 2:1 they got olaparib or placebo.

Andres Poveda presented the first overall survival advantage. I think it was important for 3 reasons. It really is that milestone presentation where overall survival is statistically and clinically significantly advanced, more than a year extra survival, extra life, the participants who got olaparib. That's with a 38% crossover in the placebo arm.

The fact that 12.9, nearly 13 months, more than a year, overall survival advantage is able to be demonstrated where there's clearly crossover and patients live for years after initiating switch maintenance PARP inhibitor therapy, really very exciting, a coming of age where we really can say to patients it's not just delaying recurrence but truly impacting overall survival.

And then, really, a little bit moderated by the fact that in the PARP inhibitor arm, 8% of patients actually did eventually develop either MDS or acute myelogenous leukemia, a catastrophic complication, but this is 5‑year follow‑up as opposed to the 2‑year follow‑up when the PFS was presented by Eric Pujade‑Lauraine. It reminds us about the necessity for full disclosure and truly informed consent there.

Unequivocally, in patients who carry a BRCA mutation, who've had a lot of platinum prior exposure, PARP inhibitors are unequivocally associated with that catastrophic consequence of disrupting DNA, but that should not stop anybody getting switch maintenance PARP inhibitor when they carry a BRCA mutation, because the >1 year survival advantage really does change the timeline for patients.

For us, looking at the ASCO abstract, it really does change the timeline. We've moved into an age where treatment, chemotherapy and surgery, clearly gets patients into a state where biological therapies can really meaningfully impact survival for our patients.

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