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Kathleen N. Moore, MD, Associate Director of Clinical Research, Gynecologic Oncologist, Stephenson Cancer Center, University of Oklahoma, investigates the impact of the SOLO-1 trial in the field of ovarian cancer In particular, the benefits of olaparib (Lynparza) highlight the importance of using genetic testing to inform treatment decisions.
In the Phase III SOLO-1 study, olaparib treatment resulted in a 70% reduction in the risk of disease progression or death in patients BRCAadvanced mutant ovarian cancer that wholly or partially responded to platinum-based chemotherapy (HR, 0.30, 95% CI, 0.23 to 0.41; P <0.0001) versus placebo after platinum-based chemotherapy.
The effect of the SOLO-1 trial is still felt internationally, says Moore, because the efficacy of olaparib was greater than expected in this patient population. Median progression-free survival with olaparib was not reached after a median follow-up at 41 months.
It is known that all patients with ovarian cancer should be offered genetic testing and should not undergo sprouting. BRCA test and expand to include somatic BRCA mutations. However, as a result of these findings, it is in patients' best interest to undergo this test much sooner, she adds.
Research is underway and reflects the challenges of how doctors should test for germ line or somatic BRCA mutations, what type of test should be done, and what is done first. According to Moore, testing challenges are even more difficult abroad outside the United States. The impact of SOLO-1 is first and foremost on the efficacy of olaparib, but secondly, it will encourage physicians to standardize the tests, she concludes.
Based on SOLO-1 results, the FDA has approved olaparib as maintenance therapy for patients with deleterious or suspected deleterious germline or somatic lineage. BRCAadvanced epithelial mutated, primary or peritoneal cancer of the fallopian tube, in complete or partial response to platinum-based first-line chemotherapy, approved by an FDA-approved companion diagnostic test in December 2018.
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