Olaparib (LYNPARZA)

Prostate cancer, BRCA-mutated, metastatic, castration resistant

Ovarian cancer, BRCA-mutated advanced

Ovarian cancer, BRCA-mutated relapsed

Breast cancer, BRCA-mutated early stage

Prostate cancer BRCA-mutated, metastatic, castration resistant

• Dose – Oral:  300 mg twice daily continuously until disease progression or unacceptable toxicity
• Given both as monotherapy or in combination with abiraterone + prednisone

Ovarian cancer, BRCA-mutated advanced

• Dose – Oral:  300 mg twice daily continuously up to two years

Ovarian cancer, BRCA-mutated relapsed

• Dose – Oral:  300 mg twice daily continuously until disease progression or unacceptable toxicity

Breast cancer, BRCA-mutated early stage

• Dose – Oral:  300 mg twice daily continuously up to one year

Available as 100 mg and 150 mg tablets. Tablets should NOT be crushed or broken. Store at 2-30°C in original packaging.

PARP (poly (ADP-ribose) polymerase) Inhibitor

Take with or without food

If a dose is missed, patients should be instructed not to take the missed dose but to resume with the next scheduled dose.

Common: Anemia, Neutropenia, Thrombocytopenia, Diarrhea, Nausea, Fatigue.

Less Common: Rash, Decreased appetite, Secondary myelodysplastic syndrome/acute myeloid leukemia (MDS/AML), Pneumonitis.

The adverse effects listed above are not exhaustive. Please refer to the relevant product monograph for full details.

Baseline before treatment: CBC & differential, platelets, creatinine, sodium, potassium, ALT, bilirubin, alkaline phosphatase, ECG (if clinically indicated).

During treatment: CBC & differential, platelets.

If clinically indicated: creatinine, sodium, potassium, PSA, ALT, bilirubin, alkaline phosphatase, total protein, albumin, GGT, LDH, BUN.

Some patients may require evaluation of CBC & differential, platelets on Day 14.

• This drug can impact or be impacted by metabolic enzymes for absorption and excretion. Many drugs can also affect or be affected by these enzymes, so please consult with pharmacy to assess for interactions.
• Avoid grapefruit, grapefruit juice, Seville oranges, or Seville orange juice.
• Current drug interaction databases should be consulted for more information.

• Avoid in pregnancy and lactation.
• Pneumonitis has been reported in a small number of patients, monitor patients for new or worsening respiratory symptoms such as dyspnea, cough and fever.
• Secondary MDS or AML may occur, and fatal cases have been reported.
• Neutropenia is a common toxicity, assess promptly for any signs of fever and or infection.

BC Cancer. BC Cancer Drug Manual. Olaparib. Vancouver, British Columbia: BC Cancer Agency. Available at: http://www.bccancer.bc.ca/drug-database-site/Drug%20Index/Olaparib_monograph.pd. Updated September 1, 2023. Accessed January 22, 2024.

Lexicomp. Olaparib Monograph. In: Lexi-Drugs. Hudson, Ohio: Lexi-Comp, Inc. Available at: https://online.lexi.com/lco/action/doc/retrieve/docid/patch_f/5462264?cesid=7uox9Tli8PB&searchUrl=%2Flco%2Faction%2Fsearch%3Fq%3Dolaparib%26t%3Dname%26acs%3Dfalse%26acq%3Dolaparib. Updated January 24, 2024. Accessed January 25, 2024.

Cancer Care Ontario. Olaparib Monograph. Drug Formulary. Toronto, Ontario: Cancer Care Ontario. Available at:https://www.cancercareontario.ca/en/drugformulary/drugs/monograph/54086 . Updated November 2023. Accessed January 22, 2024.

AstraZeneca Canada Inc. LYNPARZA® Product Monograph. Mississauga, Ontario: AstraZeneca Canada Inc. Updated May 31, 2021