What is Lynparib/Olaparib and what are its indications?

Lynparza (Olaparib) is a drug used for the maintenance treatment of adults with BRCA-mutated advanced ovarian cancer. It is a PARP inhibitor that inhibits poly(ADP-ribose) polymerase (PARP), an enzyme involved in DNA repair. It fights cancers in people with inherited BRCA1 or BRCA2 mutations, including some ovarian, breast and prostate cancers. According to the approved indications for olaparib, it is mainly suitable for the treatment of the following conditions:

1. Ovarian cancer:

(1) First-Line Maintenance Therapy for BRCA-mutated Advanced Ovarian Cancer: Maintenance therapy for adult patients with deleterious or suspected deleterious germline or somatic BRCA-mutated advanced epithelial ovarian, fallopian tube, or primary peritoneal cancer who have a complete or partial response to first-line platinum-based chemotherapy.

(2) First-Line Maintenance Treatment of HRD-Positive Advanced Ovarian Cancer: In combination with bevacizumab, for the maintenance treatment of adult patients with advanced epithelial ovarian, fallopian tube, or primary peritoneal cancer who have a complete or partial response to first-line platinum-based chemotherapy and whose cancer is associated with homologous recombination deficiency (HRD)-positive status defined as follows: deleterious or suspected deleterious BRCA mutations, and/or genomic instability.

(3) Maintenance therapy for BRCA-mutated recurrent ovarian cancer: Maintenance therapy for adult patients with deleterious or suspected deleterious germline or somatic BRCA-mutated recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer who have a complete or partial response to platinum-based chemotherapy.

2. Breast cancer:

(1) Adjuvant therapy for BRCA-mutated HER2-negative high-risk early breast cancer: Adjuvant therapy for adult patients with harmful or suspected harmful gBRCAm human epidermal growth factor receptor 2 (HER2)-negative high-risk early ovarian cancer who have received neoadjuvant or adjuvant chemotherapy.

(2) BRCA-mutated HER2-negative metastatic breast cancer: Adult patients with deleterious or suspected deleterious gBRCAm, HER2-negative metastatic cancer who have received chemotherapy in the neoadjuvant, adjuvant, or metastatic setting. Patients with hormone receptor (HR)-positive breast cancer should have received prior endocrine therapy or be considered unsuitable for endocrine therapy.

3. Pancreatic cancer:

(1) First-line maintenance therapy for BRCA-mutated metastatic pancreatic cancer: Maintenance therapy for adult patients with deleterious or suspected deleterious gBRCAm metastatic pancreatic cancer who have not progressed on at least 16 weeks of first-line platinum-based chemotherapy.

4. Prostate cancer:

(1) HRR-mutated metastatic castration-resistant prostate cancer (mCRPC): Adult patients with deleterious or suspected deleterious germline or somatic homologous recombination repair (HRR)-mutated mCRPC who have progressed on prior treatment with enzalutamide or abiraterone.

(2) BRCA-mutated mCRPC: In combination with abiterone, prednisone, or prednisone for the treatment of adult patients with deleterious or suspected deleterious BRCA-mutated (BRCAm) mCRPC.