Olaparib treatment in patients (pts) with platinum-sensitive relapsed (PSR) ovarian cancer (OC) by BRCA mutation (BRCAm) and homologous recombination deficiency (HRD) status: Phase II LIGHT study.

Authors

null

Karen Anne Cadoo

Memorial Sloan Kettering Cancer Center, New York, NY

Karen Anne Cadoo , Fiona Simpkins , Cara Amanda Mathews , Nashwa Kabil , James Bennett , Carol Aghajanian

Organizations

Memorial Sloan Kettering Cancer Center, New York, NY, Department of Obstetrics and Gynecology, Jordan Center for Gynecologic Oncology at the Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, Program in Women’s Oncology, Department of Obstetrics and Gynecology, Women and Infants Hospital, Brown University, Providence, RI, AstraZeneca, Gaithersburg, MD, AstraZeneca, Cambridge, United Kingdom

Research Funding

Pharmaceutical/Biotech Company
AstraZeneca Pharmaceuticals LP

Background: In Study 19 (NCT00753545), olaparib capsules demonstrated improvement in progression-free survival (PFS) vs placebo in the PSR OC maintenance setting, irrespective of BRCAm status (Ledermann et al. Lancet Oncol 2014). LIGHT is the first prospective study to evaluate olaparib tablet treatment in PSR OC pts by BRCAm and HRD status. Methods: This is an open-label, non-randomized study (NCT02983799) that assessed efficacy and safety of olaparib monotherapy (300 mg BID) in pts with PSR, high-grade serous/endometrioid epithelial OC and ≥1 prior line of platinum chemotherapy. Pts were assigned to one of four cohorts: germline (g) BRCAm; somatic (s) BRCAm; HRD+ve (non-BRCAm); HRD–ve; by Myriad BRACAnalysis CDx and myChoice tests. HRD+ve was a score ≥42. Primary endpoint was objective response rate (ORR). Secondary endpoints included: disease control rate (DCR) and investigator-assessed PFS (RECIST v1.1). Primary analysis was to be ~6 months (mo) after the last pt was enrolled. Results: Data cut off was 8/27/19. Of 271 pts treated (median of 31.7 weeks [2.1–96.0]), 270 had measurable disease at baseline and were included in efficacy analyses (Table). The most common treatment-emergent adverse events (AEs) were nausea (66%) and fatigue (62%).Serious AEs and Grade ≥3 AEs were experienced by 25% and 44% of pts, respectively. AEs leading to olaparib dose interruptions, reductions and discontinuations occurred in 33%, 24% and 4% of pts, respectively. Conclusions: Olaparib treatment demonstrated activity across all cohorts. As observed in the maintenance setting, similar efficacy was seen in the gBRCAm and sBRCAm cohorts. For non-BRCAm pts, longer median PFS and higher ORR were observed in the HRD+ve cohort. Olaparib treatment was well tolerated with no new safety signals identified and a safety profile consistent with that seen in the PSR and first-line settings. Clinical trial information: NCT02983799

gBRCAm
(N=75)
sBRCAm
(N=25)
HRD+ve (non-BRCAm)
(N=68)
HRD–ve
(N=89)
Overall population
(N=270)*
≥2 prior lines of chemotherapy,
n (%)
35 (47)14 (56)37 (54)60 (67)152 (56)
ORR,
n (%)
95% CI
52 (69)
58–80
16 (64)
43–82
20 (29)
19–42
9 (10)
5–18
101 (37)
32–44
DCR,
n (%)
95% CI
72 (96)
89–99
25 (100)
86–100
54 (79)
68–88
67 (75)
65–84
230 (85)
80–89
PFS
events, n (%)
38 (51)15 (60)49 (72)76 (85)187 (69)
Median PFS,
mo
95% CI
11.0
8.3–12.2
10.8
7.3–NE
7.2
5.3–7.6
5.4
3.7–5.6
7.4
6.4–7.9

*13 pts with a Myriad test result of failed or missing were included in the overall population. CI, confidence interval; NE, not estimable

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Abstract Details

Meeting

2020 ASCO Virtual Scientific Program

Session Type

Poster Discussion Session

Session Title

Gynecologic Cancer

Track

Gynecologic Cancer

Sub Track

Ovarian Cancer

Clinical Trial Registration Number

NCT02983799

Citation

J Clin Oncol 38: 2020 (suppl; abstr 6013)

DOI

10.1200/JCO.2020.38.15_suppl.6013

Abstract #

6013

Poster Bd #

184

Abstract Disclosures