{"entity":{"id":"paper-olympia-6-year-update-ann-oncol-2026","kind":"paper","name":"Sustained benefit of adjuvant olaparib in women with germline BRCA1- and BRCA2-associated high-risk HER2-negative early breast cancer: updated results from the OlympiA phase III trial","aka":[],"tldr":"The six-year OlympiA update: the year of olaparib still cut relapse by 35 percent and death by 28 percent, six-year survival was 87.5 versus 83.2 percent, there were fewer new BRCA-related breast and ovarian cancers, and no excess of leukaemia.","summary":"Garber, Cameron, Campbell, Yothers and colleagues report the third pre-specified interim analysis of OlympiA (NCT02032823) at a median follow-up of 6.1 years, with descriptive analyses of invasive disease-free survival, distant disease-free survival and overall survival. Olaparib benefit was maintained: invasive disease-free survival hazard ratio 0.65 (95 percent confidence interval 0.53 to 0.78), distant disease-free survival 0.65 (0.53 to 0.81) and overall survival 0.72 (0.56 to 0.93); six-year overall survival was 87.5 versus 83.2 percent (difference 4.4 percentage points, 95 percent CI 0.9 to 6.7). Benefit was consistent across key subgroups including high-risk hormone receptor-positive disease. There were fewer BRCA-associated new breast and ovarian or fallopian tube cancers and no increase in adverse events of special interest (6.3 versus 9.3 percent), including myelodysplastic syndrome or acute myeloid leukaemia (0.4 versus 0.7 percent).","asOf":"2026-09-24","links":[{"label":"Ann Oncol 2026","url":"https://doi.org/10.1016/j.annonc.2026.08.002"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/42636977/"},{"label":"ClinicalTrials.gov NCT02032823","url":"https://clinicaltrials.gov/study/NCT02032823"}],"tags":["tnbc-evidence"],"related":["paper-olympia-overall-survival-ann-oncol-2022"],"cancers":["tnbc","breast-hr-positive"],"sections":[],"technologies":["parp-inhibitor"],"targets":["brca"],"drugs":["olaparib"],"companies":["astrazeneca","merck"],"institutions":[],"pathways":[],"terms":["os","germline-testing"],"trials":["olympia","keynote-522"],"people":["judy-garber","andrew-tutt"],"bottlenecks":[],"keyPapers":[],"journals":["annals-of-oncology"],"dependsOn":[],"notes":[],"journal":"Annals of Oncology","year":2026,"doi":"10.1016/j.annonc.2026.08.002","pmid":"42636977","authors":"Garber JE, Cameron D, Campbell C, et al.","paperType":"rct","findings":["At 6.1 years: invasive disease-free survival hazard ratio 0.65 (95 percent CI 0.53 to 0.78); distant disease-free survival 0.65; overall survival 0.72 (0.56 to 0.93).","Six-year overall survival 87.5 vs 83.2 percent (difference 4.4 points, 95 percent CI 0.9 to 6.7).","Myelodysplastic syndrome or acute myeloid leukaemia 0.4 vs 0.7 percent; fewer new BRCA-associated breast and ovarian cancers."],"whatItMeans":"Answers the two questions that hung over adjuvant olaparib, durability and late leukaemia, in its favour; the remaining question is whether carriers who also received pembrolizumab or capecitabine, whom the trial did not study, get the same benefit.","caveats":["Trial predates KEYNOTE-522 and CREATE-X as standards, so the combination with pembrolizumab or capecitabine is untested.","Interim analysis, descriptive by design."],"changedPractice":true,"participants":1836},"route":"/key-papers/paper-olympia-6-year-update-ann-oncol-2026/","neighbours":{"paper":[{"id":"paper-olympia-overall-survival-ann-oncol-2022","kind":"paper","name":"Overall survival in the OlympiA phase III trial of adjuvant olaparib in patients with germline pathogenic variants in BRCA1/2 and high-risk, early breast cancer","route":"/key-papers/paper-olympia-overall-survival-ann-oncol-2022/"}],"cancer":[{"id":"breast-hr-positive","kind":"cancer","name":"HR-positive / HER2-negative breast cancer","route":"/cancers/breast-hr-positive/"},{"id":"tnbc","kind":"cancer","name":"Triple-negative breast cancer (TNBC)","route":"/cancers/tnbc/"}],"technology":[{"id":"germline-testing","kind":"technology","name":"Germline (hereditary) testing","route":"/technologies/germline-testing/"},{"id":"parp-inhibitor","kind":"technology","name":"PARP inhibitors","route":"/technologies/parp-inhibitor/"}],"target":[{"id":"brca","kind":"target","name":"BRCA1 / BRCA2 (HRD)","route":"/targets/brca/"}],"drug":[{"id":"olaparib","kind":"drug","name":"Olaparib","route":"/drugs/olaparib/"}],"company":[{"id":"astrazeneca","kind":"company","name":"AstraZeneca","route":"/companies/astrazeneca/"},{"id":"merck","kind":"company","name":"Merck & Co. (MSD)","route":"/companies/merck/"}],"term":[{"id":"os","kind":"term","name":"Overall survival (OS)","route":"/terms/os/"}],"trial":[{"id":"keynote-522","kind":"trial","name":"KEYNOTE-522","route":"/trials/keynote-522/"},{"id":"olympia","kind":"trial","name":"OlympiA","route":"/trials/olympia/"}],"person":[{"id":"andrew-tutt","kind":"person","name":"Andrew Tutt","route":"/people/andrew-tutt/"},{"id":"judy-garber","kind":"person","name":"Judy E. Garber","route":"/people/judy-garber/"}],"journal":[{"id":"annals-of-oncology","kind":"journal","name":"Annals of Oncology","route":"/journals/annals-of-oncology/"}],"roadmap":[{"id":"tnbc-roadmap","kind":"roadmap","name":"Triple-negative breast cancer roadmap: from a remainder defined by three negative tests to immunotherapy, antibody-drug conjugates and the residual disease problem","route":"/roadmaps/tnbc-roadmap/"}],"idea":[{"id":"idea-tnbc-uk-trial-access-and-germline-testing-audit","kind":"idea","name":"A UK audit of trial access and germline testing uptake in triple-negative breast cancer","route":"/ideas/idea-tnbc-uk-trial-access-and-germline-testing-audit/"}]}}