Dr. Penson on Olaparib Monotherapy Vs Chemo in Ovarian Cancer

Richard T. Penson, MD, MRCP, associate professor, Harvard Medical School, and clinical director, Medical Gynecologic Oncology, Massachusetts General Hospital, compares olaparib (Lynparza) monotherapy with chemotherapy for patients with relapsed germline BRCA-mutated (gBRCAm) platinum-sensitive ovarian cancer.

In the phase III SOLO-3 trial patients were randomized 2:1 to receive olaparib tablets at a dose of 300 mg daily or physician’s choice of nonplatinum-based chemotherapy. All patients, prior to the study, received 2 or more lines of platinum-based chemotherapy.

In terms of toxicity, there were more serious adverse events (AEs) with olaparib versus chemotherapy (24% versus 18%), but patients receiving chemotherapy were more likely to discontinue treatment due to AEs. Common AEs included nausea, anemia, and neutropenia. The overall response rate was 72% with olaparib and 51% with chemotherapy. Progression-free survival was 13.4 and 9.2 months with olaparib versus chemotherapy, respectively. The SOLO-3 trial provides important data on the efficacy of these treatment options for patients with heavily pretreated relapsed platinum-sensitive gBRCAm ovarian cancer.