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Poster Discussion – Gastrointestinal tumours, non-colorectal

4511 - POLO: Health-related quality of life (HRQoL) of olaparib maintenance treatment versus placebo in patients with a germline BRCA mutation and metastatic pancreatic cancer (mPC)

Date

28 Sep 2019

Session

Poster Discussion – Gastrointestinal tumours, non-colorectal

Presenters

Pascal Hammel

Citation

Annals of Oncology (2019) 30 (suppl_5): v253-v324. 10.1093/annonc/mdz247

Authors

P. Hammel1, H.L. Kindler2, M. Reni3, E. Van Cutsem4, T. Macarulla Mercade5, M.J. Hall6, J.O. Park7, D. Hochhauser8, D. Arnold9, D. Oh10, A. Reinacher-Schick11, G. Tortora12, H. Algül13, E.M. O'Reilly14, D. McGuinness15, K.Y. Cui16, S. Joo17, H.K. Yoo18, N. Patel19, T. Golan20

Author affiliations

  • 1 Department Of Medical Oncology, Hôpital Beaujon (AP-HP), and University Paris VII, 92110 - Clichy/FR
  • 2 Department Of Medicine, University of Chicago, Chicago/US
  • 3 Department Of Oncology, IRCCS Ospedale San Raffaele Scientific Institute, 20132 - Milan/IT
  • 4 Department Of Internal Medicine, University Hospitals Gasthuisberg and KU Leuven, 3000 - Leuven/BE
  • 5 Department Of Medical Oncology, Vall d’Hebron University Hospital and Vall d’Hebron Institute of Oncology, 08035 - Barcelona/ES
  • 6 Department Of Clinical Genetics, Fox Chase Cancer Center, 19111 - Philadelphia/US
  • 7 Division Of Hematology-oncology, Department Of Medicine, Samsung Medical Center and Sungkyunkwan University School of Medicine, 06351 - Seoul/KR
  • 8 Department Of Oncology, UCL Cancer Institute, WC1E 6JD - London/GB
  • 9 Med. Abteilung, Asklepios Tumorzentrum Hamburg AK Altona, 22763 - Hamburg/DE
  • 10 Department Of Internal Medicine, Seoul National University Hospital, 110-744 - Seoul/KR
  • 11 Department Of Hematology, Oncology And Palliative, St. Josef-Hospital - Ruhr University Bochum, 44791 - Bochum/DE
  • 12 Department Of Medical Oncology, Azienda Ospedaliera Universitaria Integrata Verona, Verona/IT
  • 13 Department Of Internal Medicine Ii, Klinikum rechts der Isar, Technische Universität München, Munich/DE
  • 14 Department Of Medicine, Memorial Sloan-Kettering Cancer Center, 10065 - New York/US
  • 15 Biostatistics, AstraZeneca, Cambridge/GB
  • 16 Global Medicines Development, AstraZeneca, Gaithersburg/US
  • 17 Patient Reported Outcomes, Merck & Co., Inc., Kenilworth/US
  • 18 Payer Analytics, AstraZeneca, Cambridge/GB
  • 19 Patient Reported Outcomes, AstraZeneca, Gaithersburg/US
  • 20 Department Of Medical Oncology, The Oncology Institute, Sheba Medical Center at Tel-Hashomer, Tel Aviv University, 52621 - Tel Aviv/IL

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Abstract 4511

Background

In the Phase III POLO trial (NCT02184195) patients (pts) with a germline BRCA1 and/or BRCA2 mutation (gBRCAm) and mPC derived a statistically significant and clinically meaningful progression-free survival benefit from maintenance olaparib compared with placebo. HRQoL assessment was a predefined secondary objective.

Methods

Pts with a gBRCAm and mPC whose disease had not progressed during first-line platinum-based chemotherapy were randomized to receive maintenance olaparib tablets (300 mg bid) or placebo. Pts completed the EORTC QLQ-C30 questionnaire at baseline and every 4 wks until discontinuation, with calculated scores ranging from 1–100. A change of ≥ 10 points was predefined as clinically meaningful improvement (increase) or deterioration (decrease) for global HRQoL and physical function score. Overall adjusted mean change from baseline was analysed using a mixed model for repeated measures. Time to sustained clinically meaningful deterioration (TCMD) was analysed using a log-rank test.

Results

Analyses were conducted in 89/92 olaparib pts and 58/62 placebo pts with evaluable baseline forms (overall compliance was 96.6% and 94.8%). There was no difference between arms for global HRQoL score (Table). The adjusted mean difference for physical function scale did not reach the threshold considered to be clinically meaningful. Global HRQoL and physical function remained relatively stable over time. There was no difference in TCMD for olaparib versus placebo for global HRQoL (median 21.2 vs 6.0 mo, respectively; hazard ratio 0.72 [95% CI 0.41–1.27]) or physical function (medians not reached, 1.38 [0.73–2.63]).Table:

675PD

Global HRQoLPhysical function
Maintenance olaparibPlaceboMaintenance olaparibPlacebo
Absolute score, mean (n)
Baseline70.4 (89)74.3 (58)83.3 (89)84.9 (58)
Week 1273.6 (66)74.1 (36)84.4 (67)85.4 (36)
Week 2473.4 (41)NC87.4 (43)NC
Week 4879.0 (23)NC89.6 (23)NC
Overall change from baseline*
Adjusted mean ± SE (n)−1.2±1.4 (84)1.3±1.9 (54)−2.1±1.3 (84)2.4± 1.7 (54)
Between group difference (95% CI)−2.5 (−7.3, 2.3)−4.5 (−8.7, −0.2)
P value0.310.04
*

Pts had to have baseline and ≥1 post-baseline assessment

NC, not calculated due to insufficient numbers of values; SE, standard error

Conclusions

HRQoL was preserved during maintenance olaparib treatment with no meaningful difference versus placebo. Findings support the observed clinical benefit of maintenance olaparib in pts with a gBRCAm and mPC.

Clinical trial identification

NCT02184195.

Editorial acknowledgement

Debbi Gorman, from Mudskipper Business, Ltd, funded by AstraZeneca and Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, U.S.A.

Legal entity responsible for the study

AstraZeneca and Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, U.S.A.

Funding

AstraZeneca and Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, U.S.A.

Disclosure

P. Hammel: Research grant / Funding (institution): Celgene; Research grant / Funding (institution): AstraZeneca; Research grant / Funding (institution), Non-remunerated activity/ies: Erythec; Honoraria (self), Research grant / Funding (institution): Halozyme. H.L. Kindler: Advisory / Consultancy, Research grant / Funding (institution): AstraZeneca; Advisory / Consultancy, Research grant / Funding (institution), Travel / Accommodation / Expenses: Merck; Advisory / Consultancy: Aldeyra Therapeutics; Advisory / Consultancy: Astellas; Advisory / Consultancy, Travel / Accommodation / Expenses: Boehringer-Ingelheim; Advisory / Consultancy, Research grant / Funding (institution): Bristol-Myers Squibb; Advisory / Consultancy: Erytech; Advisory / Consultancy: Five Prime Therapeutics; Advisory / Consultancy: Ipsen Pharmaceuticals; Advisory / Consultancy: Kyowa; Advisory / Consultancy, Travel / Accommodation / Expenses: Paredox Therapeutics; Research grant / Funding (institution): Aduro; Research grant / Funding (institution): Bayer; Research grant / Funding (institution): Deciphera; Research grant / Funding (institution): GlaxoSmithKline; Research grant / Funding (institution): MedImmune; Research grant / Funding (institution): Lilly; Research grant / Funding (institution): Polaris; Research grant / Funding (institution): Verastem. M. Reni: Honoraria (self), Research grant / Funding (institution), Non-remunerated activity/ies: Celgene; Honoraria (self): Baxalta; Honoraria (self): Shire; Honoraria (self): Eli-Liily; Honoraria (self): Pfizer; Honoraria (self): Novocure; Honoraria (self): Novartis; Advisory / Consultancy, Steering committee member: AstraZeneca; Advisory / Consultancy, Steering committee member: Boston Pharmaceuticals. E. Van Cutsem: Research grant / Funding (institution): Amgen; Advisory / Consultancy, Research grant / Funding (institution): Bayer; Research grant / Funding (institution): Boehringer Ingelheim; Advisory / Consultancy, Research grant / Funding (institution): Celgene; Research grant / Funding (institution): Ipsen; Advisory / Consultancy, Research grant / Funding (institution): Lilly; Research grant / Funding (institution): Roche; Advisory / Consultancy, Research grant / Funding (institution): Merck Sharp & Dohme; Advisory / Consultancy, Research grant / Funding (institution): Merck KGaA; Advisory / Consultancy, Research grant / Funding (institution): Novartis; Advisory / Consultancy, Research grant / Funding (institution): Roche; Advisory / Consultancy, Research grant / Funding (institution): Servier; Advisory / Consultancy: AstraZeneca; Advisory / Consultancy: Bristol-Myers Squibb. T. Macarulla Mercade: Advisory / Consultancy: Genzyme; Advisory / Consultancy, Research grant / Funding (institution): Roche; Advisory / Consultancy, Travel / Accommodation / Expenses: Sanofi Aventis; Advisory / Consultancy: Shire; Advisory / Consultancy: Tesaro; Advisory / Consultancy: Baxalta; Advisory / Consultancy, Research grant / Funding (institution): Celgene; Travel / Accommodation / Expenses: H3 Biomedicine; Advisory / Consultancy: QED Therapeutics; Research grant / Funding (institution): Agios pharmaceuticals, Aslan pharmaceuticals; Research grant / Funding (institution): AstraZeneca; Research grant / Funding (institution), Travel / Accommodation / Expenses: Bayer; Research grant / Funding (institution): Genentech; Research grant / Funding (institution): Halozyme, Inc, Immunomedics, Merrimack, Millennium; Research grant / Funding (institution): Lilly; Research grant / Funding (institution): Novartis Farmaceutica S.A.; Research grant / Funding (institution): Novocure GmBH; Research grant / Funding (institution): Oncomed, Pharmacyclics; Research grant / Funding (institution): Pfizer S.L.U.; Travel / Accommodation / Expenses: Merck. M.J. Hall: Research grant / Funding (institution), Travel / Accommodation / Expenses, Non-remunerated activity/ies: AstraZeneca; Travel / Accommodation / Expenses, Non-remunerated activity/ies, Non-remunerated activities relate to collaborative research: Caris Life Sciences; Non-remunerated activity/ies, Collaborative research: Myriad; Non-remunerated activity/ies, Collaborative research: Ambry; Non-remunerated activity/ies, Collaborative research: Invitae; Non-remunerated activity/ies, Collaborative research: Foundation Medicine; Non-remunerated activity/ies: Merck. J.O. Park: Honoraria (self), Advisory / Consultancy, Research grant / Funding (self): Celgene; Honoraria (self), Advisory / Consultancy: Sanofi; Honoraria (self), Advisory / Consultancy: Shire; Advisory / Consultancy: Merck; Advisory / Consultancy: Sereno. D. Arnold: Honoraria (self): AstraZeneca; Honoraria (self), Non-remunerated activity/ies: Bayer; Honoraria (self), Non-remunerated activity/ies: Bristol-Myers Squibb; Honoraria (self): Biocompatibles; Honoraria (self): Eli Lilly; Honoraria (self), Non-remunerated activity/ies: Merck Sharpe & Dohme; Honoraria (self), Non-remunerated activity/ies: Servier; Honoraria (self), Non-remunerated activity/ies: Sanofi; Honoraria (self), Non-remunerated activity/ies: Roche; Honoraria (self): Terumo; Honoraria (self): Sirtex. D. Oh: Research grant / Funding (institution): AstraZeneca; Advisory / Consultancy: Novartis; Advisory / Consultancy: Genentech/ Roche; Advisory / Consultancy: Merck Serono; Advisory / Consultancy: Bayer; Advisory / Consultancy: Taiho; Advisory / Consultancy: Aslan; Advisory / Consultancy: Halozyme. A. Reinacher-Schick: Honoraria (self), Advisory / Consultancy, Travel / Accommodation / Expenses: Amgen; Honoraria (self), Advisory / Consultancy: Baxalta; Honoraria (self), Advisory / Consultancy: Bristol-Myers Squibb; Honoraria (self), Advisory / Consultancy, Research grant / Funding (institution), Travel / Accommodation / Expenses: Celgene; Honoraria (self), Research grant / Funding (institution): Ipsen; Honoraria (self), Advisory / Consultancy, Research grant / Funding (institution): Lilly; Honoraria (self), Advisory / Consultancy: Merck Serono; Honoraria (self), Advisory / Consultancy: Merck Sharpe & Dohme; Honoraria (self), Advisory / Consultancy: Pfizer; Honoraria (self), Advisory / Consultancy, Research grant / Funding (institution): Roche; Honoraria (self), Advisory / Consultancy: Sanofi-Aventis; Honoraria (self), Advisory / Consultancy, Travel / Accommodation / Expenses: Servier; Research grant / Funding (institution): AstraZeneca. G. Tortora: Honoraria (self), Advisory / Consultancy: Celgene; Honoraria (self), Advisory / Consultancy, Research grant / Funding (institution), Travel / Accommodation / Expenses: Merck; Honoraria (self), Advisory / Consultancy: Incyte; Honoraria (self), Advisory / Consultancy, Research grant / Funding (self), Travel / Accommodation / Expenses: Novartis. H. Algül: Honoraria (self): Celgene; Honoraria (self), Travel / Accommodation / Expenses: Servier; Research grant / Funding (institution): Chugai. E.M. O’Reilly: Advisory / Consultancy, Including spouse: 3DMedcare, Boston Scientific, CytomX, Daiichi, Debio, Delcath, Exelixis, Alignmed, Antengene, Aptus, Beigene, Bioline, Bridgebio, Carsgen, Aslan, Genoscience, Hengrui Inovio, LAM, Loxo, Mina, Novella, Onxeo, PCI Biotech, Pieris, QED, Redhill, Silenseed,; Research grant / Funding (institution), Including spouse: Actabiologica, Incyte, Array, Celgene, Mabvax, Oncoquest, Polaris, Puma; Advisory / Consultancy, Research grant / Funding (institution), Including spouse: Agios, Halozyme, Casi; Advisory / Consultancy, Including spouse: Amgen; Advisory / Consultancy, Including spouse: Astellas; Advisory / Consultancy, Research grant / Funding (institution), Including spouse: AstraZeneca; Advisory / Consultancy, Research grant / Funding (institution), Including spouse: Bayer; Advisory / Consultancy, Research grant / Funding (institution), Including spouse: BMS; Advisory / Consultancy, Including spouse: Eisai; Research grant / Funding (institution), Including spouse: Genentech; Advisory / Consultancy, Including spouse: Ipsen; Advisory / Consultancy, Including spouse: Jazz; Advisory / Consultancy, Including spouse: Janssen; Advisory / Consultancy, Including spouse: Kyowa Kirin; Advisory / Consultancy, Research grant / Funding (institution), Including spouse: Lilly; Advisory / Consultancy, Including spouse: Merck; Research grant / Funding (institution), Including spouse: Novartis; Advisory / Consultancy, Including spouse: Pfizer; Research grant / Funding (institution), Including spouse: Roche; Advisory / Consultancy, Including spouse: Sanofi; Advisory / Consultancy, Including spouse: Sillajen, Sobi, Targovax, Tekmira, Twoxar, Vicus, Yakult, Yiviva. D. McGuinness: Shareholder / Stockholder / Stock options, Full / Part-time employment: AstraZeneca. K.Y. Cui: Shareholder / Stockholder / Stock options, Full / Part-time employment: AstraZeneca. S. Joo: Shareholder / Stockholder / Stock options, Full / Part-time employment: Merck & Co., Inc. H.K. Yoo: Full / Part-time employment: AstraZeneca. N. Patel: Shareholder / Stockholder / Stock options, Full / Part-time employment: AstraZeneca. T. Golan: Honoraria (self), Research grant / Funding (institution): AstraZeneca; Research grant / Funding (institution): Merck Sharp & Dohme Corp; Honoraria (self): AbbVie; Honoraria (self): Teva. All other authors have declared no conflicts of interest.

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