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For BRCAm* aOC, 1L maintenance LYNPARZA following response to 1L platinum-based chemotherapy1
Not an actual patient.
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SEE THE STUDY DESIGN AND ADDITIONAL EFFICACY DATA, AND REVIEW IMPORTANT SAFETY INFORMATION FOR LYNPARZA.
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*Select patients for this indication based on an FDA-approved companion diagnostic for LYNPARZA.1
Primary analysis
Estimated 60% progression-free survival at 3 years
Analysis based on Kaplan–Meier estimates. Study was not designed to detect a difference at the 3-year mark.
Median PFS1
HR=0.30 (95% CI: 0.23–0.41); P<0.0001
Median duration of follow-up (primary analysis): 41 months for both LYNPARZA and placebo; DCO: May 17, 2018.5
Events, n (%): 102/260 (39) with LYNPARZA and 96/131 (73) with placebo.1
Sensitivity analysis of PFS by BICR was consistent with the investigator-assessed PFS and confirmed the robustness of the data (HR=0.28 [95% CI: 0.20–0.39]).
BICR does not form part of the multiplicity strategy in SOLO-1.
LONG-TERM PFS DATA
PFS at the post hoc 5-year follow-up analysis
~4.7 years mPFS with LYNPARZA vs ~1.2 years with placebo6
The analyses at 1, 3, and 5 years are descriptive only; the SOLO-1 trial was not designed to assess a statistical difference between treatment groups at these time points.
| LYNPARZA | Placebo | |
|---|---|---|
| Median PFS (mo) | 56 | 13.8 |
| HR=0.33 (95% CI: 0.25–0.43) | ||
Events, n (%): 118/260 (45) with LYNPARZA and 100/131 (76) with placebo.5,6
†In SOLO-1, treatment with LYNPARZA was continued for up to 2 years or until disease progression or unacceptable toxicity. Patients who remained in CR received a maximum treatment duration of 2 years; patients with evidence of disease could continue to receive LYNPARZA beyond 2 years. 26 (10%) patients on LYNPARZA continued beyond 2 years. At the time of DCO May 17, 2018, 13 patients were still receiving LYNPARZA.1,5
OVERALL SURVIVAL DATA
Descriptive interim 7-year follow-up OS analysis
Median OS was not reached with LYNPARZA vs 75.2 months (~6.3 years) with placebo2
45%
reduction in risk of death
HR=0.55 (95% CI: 0.40–0.76)
Events, n (%): 84/260 (32.3) with LYNPARZA and 65/131 (49.6) with placebo.2
Interim median OS follow-up time: ~7.3 years (median duration of follow-up was 88.9 months for the olaparib arm and 87.4 months for placebo); DCO: March 7, 2022.2
This analysis is based on Kaplan–Meier estimates and is descriptive only.
†In SOLO-1, treatment with LYNPARZA was continued for up to 2 years or until disease progression or unacceptable toxicity. Patients who remained in CR received a maximum treatment duration of 2 years; patients with evidence of disease could continue to receive LYNPARZA beyond 2 years. 26 (10%) patients on LYNPARZA continued beyond 2 years. At the time of DCO May 17, 2018, 13 patients were still receiving LYNPARZA.1,5
SOLO-1 TRIAL DESIGN
SOLO-1: A phase 3 trial evaluating PFS as a primary endpoint and OS as a key secondary endpoint in BRCAm advanced ovarian cancer1,5
‡Investigator-assessed PFS evaluated according to RECIST version 1.1.1
ORR data
SOLO-1: BRCAm patients with residual disease after platinum-based therapy
LYNPARZA (n=54) | Placebo (n=26)
Over 1 in 4 patients
with residual disease experienced a conversion to a complete response with LYNPARZA
~1 in 7 patients
with residual disease experienced a conversion to a partial response with LYNPARZA
with residual disease experienced a conversion to a partial response with LYNPARZA
These post hoc analyses should be interpreted with caution because of the modest patient numbers and baseline imbalances. Patients were prospectively classified as responders if the RECIST criteria for a CR or PR were satisfied at any time, up to and including the defined analysis cutoff point. For each treatment group, the ORR was the number of CRs and PRs divided by the number of patients in the group in the full analysis set with measurable disease at baseline. Only patients with PR and measurable disease at enrollment could achieve an objective response of CR or PR. Although this analysis is defined as post hoc in the poster, the descriptive presentation of this data is described in version 1 of the protocol.8,9 Trial was not designed to assess statistical difference between treatment groups.5,8,9
LYNPARZA is a poly (ADP-ribose) polymerase (PARP) inhibitor indicated:
For the maintenance treatment of adult patients with deleterious or suspected deleterious germline or somatic BRCA-mutated (gBRCAm or sBRCAm) advanced epithelial ovarian, fallopian tube, or primary peritoneal cancer who are in complete or partial response to first-line platinum-based chemotherapy. Select patients for therapy based on an FDA-approved companion diagnostic for LYNPARZA.
In combination with bevacizumab for the maintenance treatment of adult patients with advanced epithelial ovarian, fallopian tube or primary peritoneal cancer who are in complete or partial response to first-line platinum-based chemotherapy and whose cancer is associated with homologous recombination deficiency (HRD)-positive status defined by either:
Select patients for therapy based on an FDA-approved companion diagnostic for LYNPARZA.
For the maintenance treatment of adult patients with deleterious or suspected deleterious germline or somatic BRCA-mutated (gBRCAm or sBRCAm) recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer, who are in complete or partial response to platinum-based chemotherapy. Select patients for therapy based on an FDA-approved companion diagnostic for LYNPARZA.
For the adjuvant treatment of adult patients with deleterious or suspected deleterious gBRCAm, human epidermal growth factor receptor 2 (HER2)-negative, high-risk early breast cancer who have been treated with neoadjuvant or adjuvant chemotherapy. Select patients for therapy based on an FDA-approved companion diagnostic for LYNPARZA.
For the treatment of adult patients with deleterious or suspected deleterious gBRCAm, human epidermal growth factor receptor 2 (HER2)-negative metastatic breast cancer who have been treated with chemotherapy in the neoadjuvant, adjuvant, or metastatic setting. Patients with hormone receptor (HR)-positive breast cancer should have been treated with a prior endocrine therapy or be considered inappropriate for endocrine therapy. Select patients for therapy based on an FDA-approved companion diagnostic for LYNPARZA.
For the maintenance treatment of adult patients with deleterious or suspected deleterious gBRCAm metastatic pancreatic adenocarcinoma whose disease has not progressed on at least 16 weeks of a first-line platinum-based chemotherapy regimen. Select patients for therapy based on an FDA-approved companion diagnostic for LYNPARZA.
For the treatment of adult patients with deleterious or suspected deleterious germline or somatic homologous recombination repair (HRR) gene-mutated metastatic castration-resistant prostate cancer (mCRPC) who have progressed following prior treatment with enzalutamide or abiraterone. Select patients for therapy based on an FDA-approved companion diagnostic for LYNPARZA.
In combination with abiraterone and prednisone or prednisolone (abi/pred) for the treatment of adult patients with deleterious or suspected deleterious BRCA-mutated (BRCAm) metastatic castration-resistant prostate cancer (mCRPC). Select patients for therapy based on an FDA-approved companion diagnostic for LYNPARZA.
There are no contraindications for LYNPARZA.
Most common adverse reactions (all Grades) in ≥10% of patients who received LYNPARZA in the first-line maintenance setting for SOLO-1 were: nausea (77%), fatigue (67%), abdominal pain (45%), vomiting (40%), anemia (38%), diarrhea (37%), constipation (28%), upper respiratory tract infection/influenza/nasopharyngitis /bronchitis (28%), dysgeusia (26%), decreased appetite (20%), dizziness (20%), neutropenia (17%), dyspepsia (17%), dyspnea (15%), leukopenia (13%), urinary tract infection (13%), thrombocytopenia (11%), and stomatitis (11%).
Most common laboratory abnormalities (Grades 1-4) in ≥25% of patients who received LYNPARZA in the first-line maintenance setting for SOLO-1 were: decrease in hemoglobin (87%), increase in mean corpuscular volume (87%), decrease in leukocytes (70%), decrease in lymphocytes (67%), decrease in absolute neutrophil count (51%), decrease in platelets (35%), and increase in serum creatinine (34%).
Most common adverse reactions (Grades 1-4) in ≥10% of patients treated with LYNPARZA/bevacizumab and at a ≥5% frequency compared to placebo/bevacizumab in the first-line maintenance setting for PAOLA-1 were: nausea (53%), fatigue (including asthenia) (53%), anemia (41%), lymphopenia (24%), vomiting (22%), and leukopenia (18%). In addition, the most common adverse reactions (≥10%) for patients receiving LYNPARZA/bevacizumab irrespective of the frequency compared with the placebo/bevacizumab arm were: diarrhea (18%), neutropenia (18%), urinary tract infection (15%), and headache (14%).
In addition, venous thromboembolism occurred more commonly in patients receiving LYNPARZA/bevacizumab (5%) than in those receiving placebo/bevacizumab (1.9%).
Most common laboratory abnormalities (Grades 1-4) in ≥25% of patients for LYNPARZA in combination with bevacizumab in the first-line maintenance setting for PAOLA-1 were: decrease in hemoglobin (79%), decrease in lymphocytes (63%), increase in serum creatinine (61%), decrease in leukocytes (59%), decrease in absolute neutrophil count (35%), and decrease in platelets (35%).
Most common adverse reactions (Grades 1-4) in ≥20% of patients who received LYNPARZA in the maintenance setting for SOLO-2 were: nausea (76%), fatigue (including asthenia) (66%), anemia (44%), vomiting (37%), nasopharyngitis/upper respiratory tract infection (URI)/sinusitis/rhinitis/influenza (36%), diarrhea (33%), arthralgia/myalgia (30%), dysgeusia (27%), headache (26%), decreased appetite (22%), and stomatitis (20%).
Most common laboratory abnormalities (Grades 1-4) in ≥25% of patients who received LYNPARZA in the maintenance setting for SOLO-2 were: increase in mean corpuscular volume (89%), decrease in hemoglobin (83%), decrease in leukocytes (69%), decrease in lymphocytes (67%), decrease in absolute neutrophil count (51%), increase in serum creatinine (44%), and decrease in platelets (42%).
Most common adverse reactions (Grades 1-4) in ≥10% of patients who received LYNPARZA in the adjuvant setting for OlympiA were: nausea (57%), fatigue (including asthenia) (42%), anemia (24%), vomiting (23%), headache (20%), diarrhea (18%), leukopenia (17%), neutropenia (16%), decreased appetite (13%), dysgeusia (12%), dizziness (11%), and stomatitis (10%).
Most common laboratory abnormalities (Grades 1-4) in ≥25% of patients who received LYNPARZA in the adjuvant setting for OlympiA were: decrease in lymphocytes (77%), increase in mean corpuscular volume (67%), decrease in hemoglobin (65%), decrease in leukocytes (64%), and decrease in absolute neutrophil count (39%).
Most common adverse reactions (Grades 1-4) in ≥20% of patients who received LYNPARZA in the metastatic setting for OlympiAD were: nausea (58%), anemia (40%), fatigue (including asthenia) (37%), vomiting (30%), neutropenia (27%), respiratory tract infection (27%), leukopenia (25%), diarrhea (21%), and headache (20%).
Most common laboratory abnormalities (Grades 1-4) in ≥25% of patients who received LYNPARZA in the metastatic setting for OlympiAD were: decrease in hemoglobin (82%), decrease in lymphocytes (73%), decrease in leukocytes (71%), increase in mean corpuscular volume (71%), decrease in absolute neutrophil count (46%), and decrease in platelets (33%).
Most common adverse reactions (all Grades) in ≥10% of patients who received LYNPARZA in the first-line maintenance setting for POLO were: fatigue (60%), nausea (45%), abdominal pain (34%), diarrhea (29%), anemia (27%), decreased appetite (25%), constipation (23%), vomiting (20%), back pain (19%), arthralgia (15%), rash (15%), thrombocytopenia (14%), dyspnea (13%), neutropenia (12%), nasopharyngitis (12%), dysgeusia (11%), and stomatitis (10%).
Most common laboratory abnormalities (Grades 1-4) in ≥25% of patients who received LYNPARZA in the first-line maintenance setting for POLO were: increase in serum creatinine (99%), decrease in hemoglobin (86%), increase in mean corpuscular volume (71%), decrease in lymphocytes (61%), decrease in platelets (56%), decrease in leukocytes (50%), and decrease in absolute neutrophil count (25%).
Most common adverse reactions (Grades 1-4) in ≥10% of patients who received LYNPARZA for PROfound were: anemia (46%), fatigue (including asthenia) (41%), nausea (41%), decreased appetite (30%), diarrhea (21%), vomiting (18%), thrombocytopenia (12%), cough (11%), and dyspnea (10%).
Most common laboratory abnormalities (Grades 1-4) in ≥25% of patients who received LYNPARZA for PROfound were: decrease in hemoglobin (98%), decrease in lymphocytes (62%), decrease in leukocytes (53%), and decrease in absolute neutrophil count (34%).
Most common adverse reactions (Grades 1-4) in ≥10% of patients who received LYNPARZA/abiraterone with a difference of ≥5% compared to placebo/abiraterone for PROpel were: anemia (48%), fatigue (including asthenia) (38%), nausea (30%), diarrhea (19%), decreased appetite (16%), lymphopenia (14%), dizziness (14%), and abdominal pain (13%).
Most common laboratory abnormalities (Grades 1-4) in ≥20% of patients who received LYNPARZA/abiraterone for PROpel were: decrease in hemoglobin (97%), decrease in lymphocytes (70%), decrease in platelets (23%), and decrease in absolute neutrophil count (23%).
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