From the Guidelines
The recommended duration of adjuvant olaparib therapy for patients with BRCA1-related ovarian cancer is 2 years (24 months) of continuous treatment. This recommendation is based on the guideline from the Journal of Clinical Oncology 1, which suggests that olaparib maintenance therapy should consist of 300 mg orally every 12 hours for 2 years. The dose of olaparib is typically 300 mg (two 150 mg tablets) taken twice daily, for a total daily dose of 600 mg.
Key Points to Consider
- The 2-year duration of olaparib therapy represents a balance between maximizing the protective effect of the PARP inhibitor while limiting long-term toxicities, as suggested by the guideline 1.
- Patients should be monitored regularly during treatment for common side effects including fatigue, nausea, anemia, and neutropenia.
- Complete blood counts should be checked monthly for the first year and periodically thereafter.
- If significant toxicities occur, dose reductions to 250 mg twice daily or 200 mg twice daily may be implemented rather than discontinuing therapy entirely, although this is not explicitly stated in the provided guideline 1.
Additional Considerations
- After completing the 2-year course, patients should continue regular follow-up with their oncologist for surveillance.
- Longer duration of olaparib therapy could be considered in selected individuals, as stated in the guideline 1, but the specific criteria for this are not defined.
From the Research
Duration of Olaparib Adjuvant Therapy
- The duration of olaparib (Lynparza) adjuvant therapy for BRCA1 related ovarian cancer is up to 2 years, as stated in the SOLO1 trial 2.
- In the SOLO1 trial, the median treatment duration was 24.6 months (IQR 11.2-24.9) in the olaparib group and 13.9 months (8.0-24.8) in the placebo group 2.
- The SOLO2/ENGOT-Ov21 trial also mentions a treatment duration of up to 2 years, with a median treatment duration not specified 3, 4.
- A subgroup analysis of the SOLO1 trial found that maintenance olaparib significantly improved progression-free survival in patients with newly diagnosed BRCA1- and/or BRCA2-mutated advanced ovarian cancer, with a treatment duration of up to 2 years 5.
- The tolerability of maintenance olaparib in newly diagnosed patients with advanced ovarian cancer and a BRCA mutation was analyzed in the SOLO1 trial, with a treatment duration of up to 2 years 6.
Key Findings
- The SOLO1 trial demonstrated that maintenance olaparib provided a substantial progression-free survival benefit in patients with newly diagnosed, advanced ovarian cancer and a BRCA mutation who were in response after platinum-based chemotherapy 2, 6, 5.
- The SOLO2/ENGOT-Ov21 trial showed that olaparib tablet maintenance treatment provided a significant progression-free survival improvement with no detrimental effect on quality of life in patients with platinum-sensitive, relapsed ovarian cancer and a BRCA1/2 mutation 3, 4.