Reshma Shinde, MBBS, MPH1; Eric Sarpong, PhD1; Puneet Singhal, PhD, PharmB, MS1
1Merck & Co, Inc, Kenilworth, NJ, USA
Olaparib (Lynparza) is a PARP inhibitor approved for treatment in patients with germline BRCA (gBRCA)–mutated, HER2-negative metastatic breast cancer (mBC), since January 2018 in the US. Currently, real-world evidence for demographic, clinical, and treatment characteristics of patients with mBC receiving olaparib is limited.
Materials and methods
This retrospective US claims database analysis using the MarketScan Commercial Claims and Encounters database included patients with mBC receiving olaparib from January 1, 2015 to September 30, 2019. Demographic and clinical characteristics, including hormone receptor (HR) status (HR+ vs non–HR+), were described for the entire study population. Treatment history was described for patients with incident mBC overall and according to HR+ status.
A total of 125 patients with mBC (HR+, n = 64; non–HR+, n = 61) receiving olaparib were identified. Mean age at time of olaparib administration was 52 years (SD, 11.53 years). Patients had a mean (SD) of 2 (1.14) secondary metastatic sites, the majority of which showed bone metastasis (57%). Mean (SD) Charlson Comorbidity Index calculated during the 12-month period before olaparib administration was 7.92 (2.09). A steady increase in olaparib uptake was observed over the study period (16 in 2017; 63 in 2018; 46 up through 9 of 30 in 2019). Among patients with incident mBC (N = 98), 16%, 24%, 26%, and 44% patients received olaparib at first- (1L), second- (2L), third- (3L), and fourth- or greater (4L+) lines, respectively, with the majority (80%) receiving it as monotherapy (HR+ = 78%; non–HR+ = 91%). Most patients with incident HR+ disease (N = 54) received olaparib at a later line (3L = 22%; 4L+ = 63%), whereas most patients with incident non–HR+ disease (N = 44) received olaparib at initial lines (1L = 23%; 2L = 34%). Of the 16 patients with incident mBC on 1L olaparib, 9 received subsequent lines of therapies. Of the patients receiving olaparib as 2L therapy, all patients with HR+ disease (N = 9) received hormonal therapy as monotherapy (N = 5) or in combination with chemotherapy/CDK4/6 inhibitors (N = 4) at 1L, whereas patients with non–HR+ disease (N = 15) mostly received platinum/paclitaxel-based therapy (N = 10) at 1L.
This study provides descriptive information on clinical, demographic, and treatment patterns of olaparib use in real-world settings since its approval. The results show that olaparib was mostly administered as monotherapy and was received mostly at later lines by patients with HR+ disease and earlier lines by patients with non–HR+ disease. Further examination of real-world effectiveness of olaparib in mBC is needed.