Piotr Wysocki, Professor of Medicine and Head of the Department of Oncology at Jagiellonian University Hospital, shared on LinkedIn:

“Olaparib, used for 12 months as adjuvant treatment in BRCA1/2-mutation carriers diagnosed with high-risk HER2-negative breast cancer, has been shown to significantly improve outcomes compared to placebo after standard (neo)adjuvant treatment. In the pivotal OlympiA study, olaparib significantly improved overall survival (OS) – HR 0.68; 98.5% CI 0.47–0.97 and invasive disease-free survival (IDFS) – HR 0.63; 95% CI 0.50–0.78. However, little was known regarding the impact of active adjuvant treatment on patients’ quality of life.

In a paper published in print in the Journal of Clinical Oncology, Ganz P et al. evaluated patients-reported outcomes collected within the OlympiA study. Data were collected before random assignment and at 6, 12, 18, and 24 months. Among 1530 analyzed patients:

• The severity of fatigue (primary endpoint) was statistically significantly (but not clinically meaningfully – according to prespecified criteria) greater for olaparib than placebo at 6 and 12 months. There were no significant differences in fatigue severity between treatment groups at 18 and 24 months.
• The severity of nausea and vomiting was worse (clinically meaningful) in patients treated with olaparib compared with placebo at 6 and 12 months.

The analysis of patient-reported outcomes helps us to advise our high-risk, HER2-negative breast cancer patients with germinal BRCA1/2 mutations to undergo adjuvant therapy with us that olaparib and assure them that the treatment will be well tolerated with minimal impact on the quality of their life.

However, we should not forget to give our patients anti-nausea/vomiting prophylaxis. Personally, for my patients complaining about these adverse events, I consider using low (5 mg daily) doses of olanzapine (no interaction with PARPi).”

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Source: Piotr Wysocki/LinkedIn

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