POLO final overall survival: maintenance olaparib versus placebo in germline BRCA-mutated metastatic pancreatic cancer
The final results of POLO showed that olaparib did not lengthen overall survival on average, although about twice as many patients on olaparib were alive at three years, and the drug delayed the time until a second treatment was needed.
Overview
Prespecified final overall survival analysis of the POLO trial (154 patients with a germline BRCA mutation and platinum-sensitive metastatic pancreatic cancer). Median overall survival was 19.0 months with olaparib and 19.2 months with placebo (hazard ratio 0.83, not significant).
Survival curves separated late: about 34 percent of olaparib patients were alive at three years against about 18 percent on placebo. Time to second disease progression and time to second subsequent therapy favoured olaparib, and no new safety signals appeared with longer follow-up.
- Median overall survival 19.0 versus 19.2 months, hazard ratio 0.83, not statistically significant.
- Three-year survival about 34 percent with olaparib versus 18 percent with placebo.
- Time to second progression and to second subsequent therapy favoured olaparib.
Olaparib maintenance remains a standard option because of its progression-free benefit, tolerability and long-term survivors, but patients should know that it has not been shown to extend average survival.
- Crossover to PARP inhibitors after progression on placebo was allowed, which may have diluted any survival effect.
- The trial was not powered for overall survival.
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