The following is a summary of “Olaparib as Treatment Versus Nonplatinum Chemotherapy in Patients With Platinum-Sensitive Relapsed Ovarian Cancer: Phase III SOLO3 Study Final Overall Survival Results,” published in the December 2024 issue of Oncology by Scambia et al.
People with breast cancer (BRCA)-mutated platinum-sensitive relapsed ovarian cancer face limited treatment options, highlighting the need for new therapies to improve outcomes.
Researchers conducted a prospective study to evaluate overall survival (OS) and related outcomes in people with BRCA-mutated platinum-sensitive relapsed ovarian cancer treated with olaparib or nonplatinum chemotherapy.
They enrolled 266 participants who were randomly assigned 2:1 to receive olaparib tablets (300 milligrams twice daily; n = 178) or a single agent nonplatinum chemotherapy, chosen by the physicians (pegylated liposomal doxorubicin, paclitaxel, gemcitabine, or topotecan; n = 88). Outcomes assessed included OS, post hoc analysis by the number of previous chemotherapy lines, and exploratory analysis of BRCA reversion mutations.
The results showed that OS was similar between people treated with olaparib and those treated with nonplatinum chemotherapy (HR, 1.07 [95% CI, 0.76 to 1.49]; P=.71; median 34.9 and 32.9 months, respectively). Survival outcomes favored olaparib in people who had received 2 prior chemotherapy regimens (HR, 0.83 [95% CI, 0.51 to 1.38]; median 37.9 vs. 28.8 months). However, for individuals with 3 or more prior chemotherapy regimens, survival outcomes were less favorable with olaparib (HR, 1.33 [95% CI, 0.84 to 2.18]; median 29.9 vs. 39.4 months), BRCA reversion mutations were detected in 3.5% (6 of 170) of people treated with olaparib, and none of these individuals achieved an objective tumor response.
They concluded that while olaparib benefits certain patient groups, the efficacy varied with treatment history, possibly influenced by BRCA reversion mutations.
Source: ascopubs.org/doi/10.1200/JCO.24.00933
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