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PARP Inhibitor Olaparib Exceeds Expectations in BRCA+ Pancreatic Cancer Management

Michael J. Hall, MD, MS
Published Online:7:30 PM, Mon July 15, 2019

Pancreatic cancer with BRCA1 and BRCA2 mutations (frequency, 5%-15%) has shown positive responses to the PARP inhibitor olaparib (Lynparza) in preliminary trials. These data were the rationale for conducting the phase III POLO trial, which used olaparib as a maintenance treatment for patients with metastatic pancreatic cancer and a germline BRCA mutation whose first-line treatment was platinum-based chemotherapy.

Michael J. Hall, MD, MS, chair and associate professor in the Department of Clinical Genetics, Fox Chase Cancer Center, and co-researcher for the POLO trial,says physicians initially doubted the abilities of oral agents like olaparib for pancreatic disease management. So far, however, the results are promising, showing that the study is on the road to meeting its primary and secondary endpoints.

Among the 247 international trial patients with germline BRCA-mutant pancreatic cancer, progression-free survival was more significant in the olaparib group(7.4 vs 3.8 months; HR, 0.53; 95% CI, 0.35-0.82; P= .0038),and the study proved the safety of the treatment. Hall also notes that the POLO trial is the first of its kind and confirms the efficacy of the targeted treatment in a biomarker-selected population of patients with pancreatic cancer. 
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