Is Lynparza (Olaparib) the Right Treatment for Your Ovarian Cancer?

Is Lynparza the Right Treatment for Your Ovarian Cancer?
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In the last several months, I’ve had several patients ask me about the new pill used for ovarian cancer treatment. The pill my patients were referring to is Lynparza (olaparib), a PARP inhibitor that was approved by the U.S. Food and Drug Administration (FDA) on December 19, 2014.

1. What is a PARP inhibitor? And, for that matter, what is PARP?

When a strand of DNA within a cell is damaged, a family of enzymes known as PARP (poly ADP ribose polymerase) enzymes helps to repair the damage.

PARP inhibitors are drugs that block the PARP enzyme pathway used by cells to repair DNA damage in that cell. This is just one pathway of DNA repair, though.

Another pathway uses proteins encoded by BRCA genes (BRCA1 and BRCA2) to repair broken DNA. Cancer cells that lack a functioning BRCA repair pathway – such as when a BRCA1 or BRCA2 mutation exists – must rely on other DNA repair pathways, such as the PARP system. But if both the BRCA pathway and the PARP pathway are not functional, the cancer cell has lost two major ways to repair broken DNA, and (in theory) the cell dies.

2. What type of ovarian cancer is olaparib indicated for?

Olaparib (Lynparza) is the first approved PARP inhibitor for ovarian cancer. It is specifically approved as therapy for women with a BRCA mutation (or suspected mutation) and ovarian cancer who have undergone treatment with three or more prior lines of chemotherapy.

Olaparib is a type of treatment known as targeted therapy.​

One important caveat to the approval is that the BRCA mutation must be detected through an FDA-approved test. At the same time the FDA approved olaparib for ovarian cancer, they also approved the genetic test called BRACAnalysis CDx (made by Myriad Genetic Laboratories, Inc.).

This test can be ordered by your oncologist and involves taking a blood sample to send off for laboratory analysis.

3. Why was olaparib approved?

The FDA approval of olaparib happened after results of a study showed that 137 women with ovarian cancer (and an associated BRCA mutation) received the drug. These women had previously had at least three prior courses of chemotherapy treatments. The olaparib was given at a dose of 400 mg twice daily and no other cancer treatment was given along with it.

The study’s purpose was to measure the objective response rate (the percentage of patients who had partial of full shrinkage of their cancer). The study’s results showed that 34% of those women had an objective response, and the average time of this response was 7.9 months. Most of the responses were partial, meaning that the cancer did not go away entirely. Only 2% had a complete response, meaning complete disappearance of the ovarian cancer on imaging tests.

4. What are the side effects of olaparib?

Common side effects of olaparib include anemia, nausea and vomiting, fatigue, diarrhea, indigestion, headaches, decreased appetite, common cold type symptoms, cough, joint or back pain, muscle pain, and abdominal pain.

A very small number (close to 1%) of women developed a secondary blood cancer – myelodysplastic syndrome or acute myeloid leukemia – as a result of taking olaparib.

5. Can I take olaparib if I don’t have a BRCA mutation?

Right now, olaparib can’t be prescribed to treat advanced ovarian cancer in women who do not have a BRCA mutation. Clinical trials are ongoing, though, to determine whether olaparib might be helpful for this group of women. Olaparib and other PARP inhibitors are being studied as single agent therapy and in combination with other treatments, such as traditional chemotherapy.

6. How do I find out more about olaparib?

If you wonder whether this drug is right for you, you should check with your oncologist. You can also more information about the use of olaparib as a treatment for ovarian cancer on  You can search for clinical trials using olaparib through the website.


FDA News Release, 12/19/2014.

Ashworth A. A Synthetic Lethal Therapeutic Approach: Poly(ADP) Ribose Polymerase Inhibitors for the Treatment of Cancers Deficient in DNA Double-Strand Break Repairs. J Clin Oncol. 2008; 26(22): 3785-3790.

Kaufman B, Shapira-Frommer R, Schmultzler RK et al. Olaparib monotherapy in patients with advanced cancer and a germline BRCA1/2. J Clin Oncol. Epub 2014 Nov 3.

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