Epithelial ovarian cancer harbours 20% Breast Cancer gene (BRCA)1/2 mutations independently of family history. Poly ADP ribose polymerase (PARP) inhibitors (PARPi) have shown clinical activity among patients with homologous recombination deficiency (HRD) and specifically among BRCA1/2 mutation carriers. The European Medicines Agency (EMA) approved the use of olaparib as maintenance therapy "as monotherapy for the maintenance treatment of adult patients with platinum sensitive relapsed BRCA mutated (germline and/or somatic) high-grade serous epithelial ovarian, fallopian tube, or primary peritoneal cancer who are in response (complete response or partial response) to platinum-based chemotherapy". Trabectedin and Pegylated liposomal doxorubicin (PLD) have shown relevant activity in relapsed epithelial ovarian cancer. In the relapse with Treatment-free interval of last platinum (TFIp) between 6 and 12 months this efficacy translated into an increase in Overall survival (OS) and Progression free survival (PFS). There is an increase of hypersensitivity reactions (HSR) among platinum sensitive patients, that reaches 44% in third line and does not always allow for platinum use despite desensitization protocols. In relapse with TFIp between 6-12 months the use of Trabectedin+PLD is accepted in guidelines and consensus. Following clinical BRCAness criteria a group of patients that harbours up to 50% of BRCA1/2 mutations can be selected. Olaparib has been licensed according to EMA for maintenance in BRCA mutated patients after response to platinum following Study 19 phase II trial and further confirmed with phase III SOLO-2 data. However there is no evidence of the benefit of adding olaparib after Trabectedin+PLD response among BRCA1/2 carriers. The combination of Trabectedin+PLD, as well as both single drugs, have shown higher activity among BRCA1/2 carriers.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
9
Olaparib will be dispensed to patients on Day 1 and every 28 days thereafter until disease progression, unacceptable toxicity, withdraws from the study or closure of the study
ICO Badalona
Badalona, Spain
H Reina Sofía Cordoba
Córdoba, Spain
Hospital de Guadalajara
Guadalajara, Spain
Complejo Hospitalario de Jaen
Jaén, Spain
Hospital de Jerez de la Frontera
Jerez de la Frontera, Spain
Hospital Lucus Augusti
Lugo, Spain
Hospital Universitario La Paz
Madrid, Spain
Fundación Jimenez Diaz
Madrid, Spain
Hospital Ramon y Cajal
Madrid, Spain
Hospital Universitario 12 de Octubre
Madrid, Spain
...and 6 more locations
Progression free survival (PFS)
Time from date of first olaparib dose until the date of objective radiological disease progression according to modified RECIST 1.1 or death (by any cause in the absence of progression).
Time frame: Up to 24 months
Time to First Subsequent Treatment (TFST)
Time from date of first olaparib dose (treatment initiation) to date of first subsequent treatment commencement or death due to any cause if this occurs before commencement of first subsequent treatment
Time frame: Up to 24 months
Time to Second Subsequent Treatment (TSST)
Time from date of first olaparib dose (treatment initiation) to date of second subsequent treatment commencement or death due to any cause if this occurs before commencement of second subsequent treatment.
Time frame: Up to 24 months
Progression free survival 2 (PFS2)
Interval from the first olaparib dose (treatment initiation) to the earliest of the progression events subsequent to that used for the primary variable PFS, or death
Time frame: Up to 24 months
Incidence of Treatment Adverse Events
Number of Adverse Events per patient
Time frame: Up to 24 months
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