FDA Approves PARP Inhibitor Olaparib for Some BRCA-Positive Metastatic Breast Cancers

It’s the first PARP inhibitor approved in breast cancer and the first medicine approved specifically for people with breast cancer and a BRCA mutation
Breast Cancer News
January 22, 2018
By: 
Erin Rowley, Writer and Content Coordinator
Reviewed By: 
Debu Tripathy, MD

In January, the U.S. Food and Drug Administrationinfo-icon approved olaparibinfo-icon (Lynparza), a PARP inhibitorinfo-icon, for the treatment of metastaticinfo-icon, HER2-negative breast cancer in people with an inheritedinfo-icon BRCA geneinfo-icon mutationinfo-icon who have already been treated with chemotherapyinfo-icon. The medicineinfo-icon was first approved to treat BRCA-positive ovarian cancerinfo-icon in 2014.

Strong results from a breast cancer clinical trialinfo-icon of olaparib, called OlympiAD, were published last summer. After that, the medicine was granted priority review by the FDAinfo-icon because of its potential to significantly improve treatment of a serious conditioninfo-icon. This process allowed it to move through the approval process more quickly.

Background

Everyone has BRCA1info-icon and BRCA2info-icon genes. But some people are born with mutations, or errors, in these genes. The mutations can greatly increase a person’s chance of getting certain diseases, including breast and ovarian cancer. And in a person who has breast cancer, a BRCA mutation may affect how the cancer responds to different treatments.

Olaparib, part of a family of medicines called PARPinfo-icon inhibitors, is a treatment for people who test positive for a BRCA mutation and are diagnosed with breast cancer. PARP inhibitors can cause cancer cells to die by stopping an enzyme in the body, known as PARP, from repairing cancer cellinfo-icon DNA.

The OlympiAD Trial

Researchers with the phase III OlympiAD trial wanted to learn how well olaparib works compared to standard chemotherapy. The trial included 302 people, all of whom had a BRCA1 or BRCA2 mutation and metastatic breast cancer that was either hormone receptorinfo-icon-positive and HER2-negative, or triple-negative. All of the participants had been treated with chemotherapy in the past, either for early-stageinfo-icon or metastatic breast cancer. They were randomly assigned to two treatment groups:

  • 205 people took olaparib as a pill twice a day
  • 91 people were treated with one of three standard chemotherapy medicines of their doctor’s choice

The researchers found that participants in the olaparib group went longer without the cancer growing or spreading. The medianinfo-icon progression-free survivalinfo-icon was

  • 7 months in the olaparib group
  • 4.2 months in the standard chemotherapy group

They also found the cancer shrunk in

  • 59.9 percent of the olaparib group
  • 28.8 percent of the standard chemotherapy group

Olaparib had fewer serious side effects than standard chemotherapy. Its most common serious side effects were low blood cell counts, which can cause fatigueinfo-icon and increase the risk of infectioninfo-icon. Serious side effects were seen in

  • 36.6 percent of the olaparib group
  • 50.5 percent of the standard chemotherapy group

The OlympiAD trial marks the first time a PARP inhibitor showed a benefit in a phase III trialinfo-icon for people with breast cancer.

What This Means for You

As the first PARP inhibitor to be approved in breast cancer and the first medicine approved specifically for people who have breast cancer and a BRCA mutation, olaparib’s approval is exciting. It gives certain people another treatment option, one that may work better and have fewer side effects than standard chemotherapy. If you have triple-negative disease and a BRCA mutation, this may be the first time you’re able to have treatment that is not chemotherapy.

Before you get olaparib, you must have a test showing you have a harmful inherited mutation in the BRCA1 or BRCA2 genes. The FDA granted approved to a specific test called BRACAnalysis CDx, but there are other geneticinfo-icon tests available too.

Ask your doctor about olaparib, and about other PARP inhibitors, which could be available through a clinical trial.

More information about metastatic breast cancer is available here and more information about geneticsinfo-icon and family risk is available here.

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