Olaparib (PARP inhibitor) Sustains OS/IDFS Gains at 6.1 Years in gBRCA High-Risk HER2− eBC (OlympiA)

Olaparib (Lynparza), an oral PARP inhibitor that exploits homologous recombination deficiency in germline BRCA1/2–mutated tumors, was tested vs placebo for 1 year in the randomized Phase 3 OlympiA trial (NCT02032823) after completion of local therapy and (neo)adjuvant chemotherapy in high-risk HER2-negative early breast cancer (n=1,836). At median follow-up 6.1 years (third pre-specified interim analysis), benefit remained for IDFS (HR 0.65, 95% CI 0.53–0.78), DDFS (HR 0.65, 95% CI 0.53–0.81), and OS (HR 0.72, 95% CI 0.56–0.93), with 6-year OS 87.5% vs 83.2% (absolute +4.4%, 95% CI 0.9%–6.7%)—i.e., a durable survival increment beyond chemo ± endocrine therapy alone in this genetically defined, high-risk population. Safety signals stayed reassuring with fewer adverse events of special interest vs placebo (6.3% vs 9.3%) and no excess MDS/AML (0.4% vs 0.7%); the analysis also noted fewer new BRCA-associated breast/ovarian/fallopian tube cancers on olaparib.