Main Indications of Olaparib

Main Indications of Olaparib

For Ovarian Cancer and Related Cancers

Olaparib is approved for the treatment of adult patients with advanced ovarian cancer, fallopian tube cancer, or primary peritoneal cancer. It is indicated in three specific settings: first, as maintenance therapy for patients who have responded to platinum‑based chemotherapy and carry an abnormal BRCA gene (hereditary or acquired); second, in combination with bevacizumab for patients with advanced HRD‑positive disease (determined by BRCA mutation or genomic instability testing); and third, as maintenance therapy for patients with recurrent disease carrying an abnormal BRCA gene who have responded to platinum‑based chemotherapy. Approximately 70% of women with advanced ovarian cancer may relapse within three years after initial chemotherapy, and maintenance therapy can help extend progression‑free survival.

For Breast Cancer and Pancreatic Cancer

For HER2‑negative breast cancer, olaparib is indicated for patients with a hereditary BRCA mutation: in early breast cancer with a high risk of recurrence, it may be used as adjuvant therapy for one year after preoperative or postoperative chemotherapy; in metastatic breast cancer, it may be used in patients who have already received chemotherapy. For patients with hormone receptor‑positive disease, hormone therapy should be given concurrently. In pancreatic cancer, olaparib is indicated as maintenance therapy for patients with metastatic pancreatic cancer carrying a hereditary BRCA mutation, provided the cancer has not progressed after at least 16 weeks of first‑line platinum‑based chemotherapy. Studies have shown that the median progression‑free survival in the olaparib group was nearly double that of the placebo group.

For Metastatic Prostate Cancer

Olaparib has two applications in metastatic castration‑resistant prostate cancer. Option 1: In combination with abiraterone and prednisone (or prednisolone) for patients with a BRCA mutation (hereditary or acquired) whose cancer has spread and no longer responds to testosterone‑lowering therapy. Clinical data show that the combination therapy reduced the risk of disease progression or death by 76% in patients with BRCA mutations. Option 2: As monotherapy for patients with HRR gene mutations (including BRCA1, BRCA2, ATM, etc.) whose disease has progressed after prior treatment with enzalutamide or abiraterone. The median progression‑free survival was 7.4 months in the monotherapy group versus 3.6 months in the control group, with a 31% reduction in the risk of death.