NICE recommends olaparib for the treatment of ovarian and prostate cancer

The National Institute for Health and Care Excellence (NICE) has recommended the NHS funds olaparib for the maintenance treatment of advanced ovarian cancer in women with BRCA1 and 2 variants and for advanced or metastatic prostate cancer in men.

Olaparib belongs to a family of drugs called PARP inhibitors that, by blocking PARP proteins, interfere with the ability of cancer cells to repair errors in their DNA, causing further DNA damage and cell death. PARP proteins are involved in a different DNA repair pathway to the one controlled by BRCA genes, and they have been found to be particularly effective at treating different types of BRCA-related cancer such as breast, prostate as well as ovarian. Olaparib was made available for the treatment of ovarian cancer for NHS patients in England in 2019 (see BioNews 1008). This latest final draft guidance from NICE recommends it is made available for ovarian cancer patients as an ongoing treatment to prevent recurrence of the cancer.  

There are around 7500 new ovarian cancer cases in the UK every year and half of patients have a homologous recombination deficiency (HRD), such as a BRCA variant. 'We are delighted with this recommendation for women with advanced HRD-positive ovarian cancer.' said Tom Keith-Roach, president of AstraZeneca UK who make the drug. '[Olaparib] was discovered and developed in England, and it is important that UK patients can routinely and rapidly access such medicines.'

Previous multi-centre, global, clinical trials have demonstrated that use of olaparib can extend the time women live after ovarian cancer treatment, (see BioNews 973 and 1098) as well as extend the time patients live without progression of their cancer.

'This is a really significant new treatment,' Professor Iain McNeish, an oncologist at Imperial College London and director of the Ovarian Cancer Action research centre told the Daily Mail. 'For the past two decades we've relied on surgery and chemo to treat ovarian cancer, but unfortunately a large proportion of patients will relapse and ultimately die of the disease.'

'Trials show, for a large group of patients, olaparib can not only delay the return of the cancer by several years but can completely cure patients, which is very exciting.'

NICE has also recommended the NHS-funded provision of olaparib for advanced or metastatic prostate cancer patients, irrespective of the presence of a HRD mutation, such as BRCA 1 or 2.

NICE's recommendation came after new evidence from a Phase III clinical trial published in the New England Journal of Medicine. The results indicate that olaparib, in combination with abiraterone and prednisone/prednisolone, extends people's life expectancy and the time required for the cancer to progress when compared to abiraterone alone.

Keith-Roach, said: 'We are truly delighted that olaparib is now available to even more UK patients. Critically, this is the first time that patients with this form of prostate cancer will be able to access a PARP inhibitor without the need for a specific biomarker test [for identifying patients' mutations].'