Olaparib as an Up-Front Therapy to Prevent Recurrence
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/ Updated March 9th, 2022

Olaparib as an Up-Front Therapy to Prevent Recurrence

Medically Reviewed: Dr. Whitfield Growdon Written by Dr. Oliver Dorigo
Stanford University Medical Center
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Lynparza As Upfront Treatment for Ovarian Cancer

  • PARP inhibitors block the ability of cancer cells to repair damaged DNA, causing the cancerous cells to die.
  • Women with the BRCA gene mutation can receive the PARP inhibitor Lynparza (olaparib) after complete or partial response to first-line platinum-based chemotherapy.
  • PARP inhibitors do have some varying side effects, so you should speak to your oncologist about whether the treatment is right for you.
PARP inhibitors are the newest addition to ovarian cancer treatments and are getting lots of attention by oncologists. The treatment blocks the ability of cancer cells to repair damaged DNA, causing the cancerous cells to die. While PARP inhibitors have traditionally been used as a last resort after cancer has come back, new evidence from a clinical trial suggests one PARP inhibitor Olaparib (Lynparza), for usage ‘up-front’, as the treatment may help prevent recurrences later on.  We asked Dr. Oliver Dorigo, a gynecologic oncologist at Stanford Medicine, to discuss some of the details of this new trial:

PARP Inhibitors As Up-Front Treatment

Nearly all women with ovarian cancer receive as treatment a combination of surgery and chemotherapy. Unfortunately, many women experience a recurrence after the first round of chemotherapy. In other words, the cancer comes back. “Unfortunately, most of our patients with ovarian cancer develop recurrence after completion of their treatment, which includes surgery and chemotherapy,” says Dr. Dorigo.

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A clinical trial looked at preventing recurrence from occurring by giving a PARP inhibitor to patients directly after their first round of chemotherapy. The trial tested whether Olaparib should be used in ovarian cancer patients with a BRCA mutation after initial treatment (surgery and chemo) for ovarian, primary peritoneal or fallopian tube cancer.  This trial demonstrated a significant improvement in the time to recurrence in women with the BRCA mutation who received Olaparib. In fact, at three years of treatment with Olaparib, more than half of the patients had avoided a recurrence altogether.

Why BRCA?

The reason the trial focuses on women with BRCA mutations is because they are particularly susceptible to PARP inhibitors. Tumor cells with these mutations have problems repairing DNA already, and the PARP inhibitors accelerate these problems, causing cancer cells to die. Women can either have the BRCA mutation in all the cells in their body, known as a germline mutation, or in just their tumor cells, known as a somatic mutation. Women in the SOLO1 trial have germline BRCA mutations, which only 14% of women worldwide have.

Given the success of the SOLO1 trial, you should consider speaking to your doctor about taking Olaparib ‘up-front’, regardless of your genetics and cancer stage.

Learn more about the side effects of PARP inhibitors here.

Learn more about SurvivorNet's rigorous medical review process.

Dr. Oliver Dorigo is a gynecologic oncologist at Stanford University Medical Center. Read More

PARP Inhibitors For Maintenance

PARP inhibitors are an important therapy that traditionally were used after a recurrence of ovarian cancer. Now however, they are also being used for maintenance therapy after initial treatment.

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