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Stopping Olaparib

Slartibartfast
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I had a meeting with the Oncologist yesterday and it was decided to stop Olaparib for a month to see if it helps improve the ‘super’ fatigue I’ve been suffering from

PSA is currently 0.04 and I’m still taking Abiraterone and 3 monthly Triptorelin injections

I was wondering if anyone else had done this and what results they had and how long it took before their symptoms improved(if they did)

any advice is appreciated 

  • Good morning  . I have been looking into Olaparib as this is a suggestion for my husband. Interestingly it has now been approved for men without the BRCA gene. On the technical sheet for Lynparza I came across this which looks as if interruptions are allowed for up to 4 weeks. The half life of Olaparib is about 11.9 hours and the wash out period for 5 x half life is about 14 days so the implication is that it clears pretty quickly out of the system and so hopefully you will see results quickly. Another article suggests that a dose reduction could be possible? 

    Metastatic prostate cancer1,11,12

    PROpel

    LYNPARZA with abiraterone + prednisone or prednisolone

    (LYNPARZA component) (n=398)
    Discontinuations
    16%
    Reductions*
    21%
    Interruptions†
    48%

    *In PROpel, LYNPARZA dose reduction was considered after a patient resumed treatment after a dose interruption; the LYNPARZA dose was reduced to 250 mg BID. If further reduction was needed, then the dose could be reduced to 200 mg BID. If the reduced dose of 200 mg BID was not tolerated, no further dose reduction was allowed and LYNPARZA was discontinued.
    †For LYNPARZA, repeated dose interruptions in PROpel were allowed as required for a maximum of 4 weeks on each occasion.

    In PROpel, the majority of patients remained on treatment without discontinuing due to adverse reactions (84% for LYNPARZA + abi/pred)

    The most common (>2%) adverse reactions requiring dosage interruption of LYNPARZA were anemia (16%), COVID-19 (6%), fatigue (3.5%), nausea (2.8%), pulmonary embolism (2.3%), and diarrhea (2.3%); the most common (>2%) adverse reactions requiring dosage reductions of LYNPARZA were anemia (11%) and fatigue (2.5%). The most common adverse reactions that resulted in permanent discontinuation of LYNPARZA were anemia (4.3%) and pneumonia (1.5%).

    Metastatic prostate cancer1,13,14

    PROfound

    LYNPARZA

    (n=256)

    Investigator's choice of enzalutamide or abiraterone

    (n=130)

    Discontinuations
    18% 8%

    Reductions*
    22% 4%

    Interruptions†
    45% 18%

    *In PROfound, the LYNPARZA dose was reduced to 250 mg BID. If further reduction was needed, then the dose could be reduced to 200 mg BID. If the reduced dose of 200 mg BID was not tolerated, no further dose reduction was allowed and LYNPARZA was discontinued.
    †For LYNPARZA, repeated dose interruptions in PROfound were allowed as required for a maximum of 4 weeks on each occasion.

    >8 out of 10 men remained on LYNPARZA without an AR-related discontinuation

    In PROfound: The most frequent ARs leading to dose interruption of LYNPARZA were anemia (25%) and thrombocytopenia (6%), and the most frequent AR leading to reduction was anemia (16%). The AR that most frequently led to discontinuation was anemia (7%).

  • in reply to Alwayshope

    Thanks for the info.
    The consultant said they would call me in two weeks to see how I'm getting on with a view to reducing the dose after another two weeks.
    Typically I had just picked up the next months supply the day before but haven't opened them yet
    I'm sure the hospital went mind taking them back as I've seen what they cost the NHS for one months supply.
    Or maybe I can use them as part of the reduced dose.

  • in reply to Slartibartfast

    I don't think the NHS would take them back to use them, only to dispose of them. Have a look at the expiry date and decide from there. Olaparib has a shelf life of up to 18 months provided it is stored in the right conditions - under 25C.

  • in reply to Slartibartfast

    Hi  interesting about the super fatigue. I really struggled with Enzalutamide and after 4 months stopped taking it.  I didn't realise how bad I was until after about 2 weeks without it, what a difference it has made.   It is so strange how some people sail through and others really struggle on the same treatments.  I wish you well on your journey.  David

  • in reply to David2017

    I don't know if it's all in my mind but I feel much better today
    I guess I'll wait for a few days to see how I am then.

  • in reply to Slartibartfast

    I started to feel better after 48 hours but the big improvement was at about 10 days (but that was Enzalutamide). David

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