{"entity":{"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","aka":[],"tldr":"The second planned analysis of OlympiA, at 3.5 years, in which a year of olaparib tablets after standard treatment cut deaths by 32 percent in women with an inherited BRCA fault, the first time a PARP inhibitor had lengthened life in early breast cancer.","summary":"Geyer, Garber, Gelber, Yothers and colleagues report the pre-specified second interim analysis of overall survival in OlympiA, which randomised 1,836 patients with germline BRCA1 or BRCA2 pathogenic variants and high-risk HER2-negative early breast cancer to a year of olaparib or placebo after neoadjuvant or adjuvant chemotherapy, surgery and radiotherapy. With a median follow-up of 3.5 years overall survival improved (hazard ratio 0.68, 98.5 percent confidence interval 0.47 to 0.97, p=0.009); four-year overall survival was 89.8 versus 86.4 percent (difference 3.4 percentage points), four-year invasive disease-free survival 82.7 versus 75.4 percent (7.3 points) and distant disease-free survival 86.5 versus 79.1 percent (7.4 points), with benefit across major subgroups and no new safety signals, including no new acute myeloid leukaemia or myelodysplastic syndrome.","asOf":"2026-09-24","links":[{"label":"Ann Oncol 2022","url":"https://doi.org/10.1016/j.annonc.2022.09.159"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/36228963/"},{"label":"ClinicalTrials.gov NCT02032823","url":"https://clinicaltrials.gov/study/NCT02032823"}],"tags":["tnbc-evidence"],"related":["paper-olympia-nejm-2021","paper-olympia-6-year-update-ann-oncol-2026"],"cancers":["tnbc","breast-hr-positive"],"sections":[],"technologies":["parp-inhibitor","germline-testing"],"targets":["brca"],"drugs":["olaparib"],"companies":["astrazeneca","merck"],"institutions":[],"pathways":[],"terms":["os","germline-testing","hazard-ratio"],"trials":["olympia"],"people":["charles-geyer","judy-garber","andrew-tutt"],"bottlenecks":[],"keyPapers":[],"journals":["annals-of-oncology"],"dependsOn":[],"notes":[],"journal":"Annals of Oncology","year":2022,"doi":"10.1016/j.annonc.2022.09.159","pmid":"36228963","authors":"Geyer CE, Garber JE, Gelber RD, et al.","paperType":"rct","findings":["Overall survival hazard ratio 0.68 (98.5 percent CI 0.47 to 0.97), p=0.009, at 3.5 years median follow-up.","Four-year overall survival 89.8 vs 86.4 percent; invasive disease-free survival 82.7 vs 75.4 percent; distant disease-free survival 86.5 vs 79.1 percent.","No new cases of acute myeloid leukaemia or myelodysplastic syndrome."],"whatItMeans":"The survival result that moved adjuvant olaparib from a disease-free survival approval to an undisputed standard, and the reason germline testing at diagnosis of triple-negative breast cancer is now a treatment decision rather than a family history exercise.","caveats":["About 82 percent of participants had triple-negative disease; hormone receptor-positive carriers were a minority.","Interim analysis with a stricter alpha; the six-year update is the mature result."],"changedPractice":true,"participants":1836},"route":"/key-papers/paper-olympia-overall-survival-ann-oncol-2022/","neighbours":{"paper":[{"id":"paper-olympia-nejm-2021","kind":"paper","name":"OlympiA: a year of olaparib after surgery for BRCA-mutated, high-risk early breast cancer","route":"/key-papers/paper-olympia-nejm-2021/"},{"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","route":"/key-papers/paper-olympia-6-year-update-ann-oncol-2026/"}],"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":"hazard-ratio","kind":"term","name":"Hazard ratio (HR)","route":"/terms/hazard-ratio/"},{"id":"os","kind":"term","name":"Overall survival (OS)","route":"/terms/os/"}],"trial":[{"id":"olympia","kind":"trial","name":"OlympiA","route":"/trials/olympia/"}],"person":[{"id":"andrew-tutt","kind":"person","name":"Andrew Tutt","route":"/people/andrew-tutt/"},{"id":"charles-geyer","kind":"person","name":"Charles E. Geyer Jr.","route":"/people/charles-geyer/"},{"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/"}]}}