POLO Trial: Olaparib as a maintenance treatment following first-line chemotherapy in patients with metastatic pancreatic cancer

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Published: 6 Jun 2019
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Dr Teresa Macarulla - Vall d’Hebron Barcelona University Hospital, Barcelona, Spain

Dr Teresa Macarulla talks to ecancer at the 2019 American Society of Clinical Oncology (ASCO) Annual Meeting about results from the phase III POLO trial - which assessed the use of olaparib as a maintenance treatment following first-line platinum-based chemotherapy in patients with a germline BRCA1/2 mutation and metastatic pancreatic cancer, compared with a placebo.

Dr Macarulla mentions that progression-free survival was the primary endpoint of this trial, along with overall survival, response rate, quality of life and adverse events were also assessed.

She emphasises the importance of this trial, which is the first positive study in this setting and offers a novel treatment option with patients with metastatic pancreatic cancer.

Dr Macarulla also believes patients should be tested routinely for BRCA1/2 mutations, to identify the 7-8% of patients that could benefit from this treatment.

ecancer's filming has been kindly supported by Amgen through the ecancer Global Foundation. ecancer is editorially independent and there is no influence over content.

This is a phase III trial that demonstrated that in a patient with metastatic pancreatic cancer and germline BRCA1 and BRCA2 mutations that treatment with olaparib after an induction period of treatment with chemotherapy, oxaliplatin based chemotherapy, the olaparib stops the evolution of the tumour when we compare it with placebo. So after this study we have a new standard treatment for this group of patients, the patients with metastatic pancreatic cancer and germline BRCA1 or BRCA2 mutations.

The primary endpoint of the trial is the progression free survival, so we demonstrated that we can stop the evolution of the treatment but also during the trial we can measure the quality of life of the patients and it was maintained in the patients with olaparib treatment because the quality of life is better than with chemotherapy. Also the response rate of the tumour and the overall survival and, of course, the side effects of the treatment.

The most important thing is that we have for the first time in pancreatic cancer patients a positive trial with a biomarker. So we are treating only a subgroup of patients with pancreatic cancer and it’s the first positive trial in this setting. Also with this trial we have a new treatment option for the patients with metastatic pancreatic cancer for this group of patients. This is always really good news for these patients.

What are your thoughts or how important is germline testing in the clinic?

After these results, of course, we have to think if we have to test all our patients just in order to find this 7-8% of patients with positive germline BRCA mutations. So probably in the NCCN guidelines this is established that you have to test all your patients. We have to start to test in other countries and in other guidelines.