Dr. Moore on the Impact of the SOLO-1 Trial in Ovarian Cancer

Kathleen N. Moore, MD, associate director for clinical research, gynecologic oncologist at The Stephenson Cancer Center, The University of Oklahoma, explores the impact of the SOLO-1 trial in the field of ovarian cancer, in particular, the benefits olaparib (Lynparza) provides and the light it shines on the importance of using genetic testing to inform treatment decisions.

In the phase III SOLO-1 trial, treatment with olaparib led to a 70% reduction in the risk of disease progression or death in patients with BRCA-mutant advanced ovarian cancer who were in complete or partial response to platinum-based chemotherapy (HR, 0.30; 95% CI, 0.23-0.41; P <.0001) versus placebo following platinum-based chemotherapy.

The impact of the SOLO-1 trial is still being felt internationally, Moore explains, as the efficacy with olaparib was above and beyond what was expected in this patient population. The median progression-free survival with olaparib was not reached at a median 41-month follow-up.

It has been known that all patients with ovarian cancer should be offered genetic testing, and should be beyond germline BRCA testing and expand to include somatic BRCA mutations. However, following these findings, there is a push for patients to have this testing much earlier, she adds.

Research is ongoing that is reflecting the challenges of how physicians should test for germline or somatic BRCA mutations, what sort of test should be conducted, and what is done first. Globally, Moore says, the challenges to testing are even greater outside of the United States. The impact of SOLO-1 is first and foremost, to the efficacy with olaparib, but secondly, it will push physicians to standardize testing, she concludes.

Based on the SOLO-1 findings, the FDA approved olaparib as a maintenance treatment for patients with deleterious or suspected deleterious germline or somatic BRCA-mutated advanced epithelial ovarian, fallopian tube, or primary peritoneal cancer who are in complete or partial response to frontline platinum-based chemotherapy, as approved by an FDA-approved companion diagnostic assay, in December 2018.

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