olaparib treatment in relapsed germline breast cancer susceptibility gene (brca) mutated ovarian cancer patients who have progressed at least 6 months after last platinum treatment and have received at least 2 prior platinum treatments

Conditions: Relapsed Ovarian Cancer, BRCA Mutation, Platinum Sensitivity

Summary: comparison of olaparib vs. physician's choice of single agent standard of care non-platinum based chemotherapy in patients with germline breast cancer susceptibility gene (gbrca) mutated ovarian cancer who have progressed at least 6 months after the last platinum based chemotherapy. patient should have received at least 2 prior lines of platinum based chemotherapy. the aim of the study is to assess the efficacy and safety of olaparib tablets.

this open label, randomised, controlled, multi-centre study will assess the efficacy and safety of single agent olaparib vs. standard of care, based on physician's choice of single agent chemotherapy ( i.e paclitaxel, or topotecan, or pegylated liposomal doxorubicin, or gemcitabine) in platinum sensitive or partially platinum sensitive relapsed ovarian cancer patients who carry germline deleterious or suspected deleterious brca mutation and who have received at least 2 prior lines of platinum based chemotherapy. patients are eligible to undergo brca testing even if they have not yet had recurrence or progression of disease \>6 months (\>/=183 days) after completion of their last platinum therapy.

Eligibility criteria:
inclusion criteria: * patients must be ≥ 18 years of age * patients with histologically diagnosed relapsed high grade serous ovarian cancer (including primary peritoneal and/or fallopian tube cancer) or high grade endometrioid cancer. patients are eligible to undergo brca testing even if they have not yet had recurrence or progression of disease \>6 months (\>/=183 days) after completion of their last platinum therapy. * documented germline mutation in breast cancer susceptibility genes: brca1 and/or brca2 that is predicted to be deleterious or suspected deleterious (known or predicted to be detrimental/lead to loss of function) * at least one lesion that can be accurately assessed at baseline by ct/mri and is suitable for repeated assessment. * patients must have received at least 2 prior platinum based lines of chemotherapy - patients must be partially platinum sensitive or platinum sensitive * patients must be suitable to start treatment with single agent chemotherapy based on physician's choice * patients must have normal organ and bone marrow function measured within 28 days of randomisation, * eastern cooperative oncology group (ecog) performance status 0-2 * patients must have a life expectancy ≥ 16 weeks * formalin fixed, paraffin embedded tumour sample from the primary or recurrent cancer must be available for central testing. exclusion criteria: * brca 1 and/or brca2 mutations that are considered to be non detrimental * exposure to any investigational product within 30 days or 5 half lives (whichever is longer) prior to randomisation * any previous treatment with a polyadenosine 5'diphosphoribose polymerisation (parp) inhibitor, including olaparib. * patients who have platinum resistant or refractory disease * patients receiving any systemic chemotherapy within 3 weeks prior to first dose of study treatment * previous single agent exposure to the selected chemotherapy regimen for randomisation. - prior malignancy in the last 5 years, unless curatively treated and recurrence free (few exceptions apply).

Keywords: brca, ovarian, platinum, chemotherapy,