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Abstract
Background and Objectives To report the tolerability and efficacy of olaparib with temozolomide (TMZ) for glioma.
Methods Single-center retrospective series of patients with glioma treated with olaparib/TMZ from September 2018 to December 2021.
Results Twenty patients (median age: 42 years, median Karnofsky Performance Status: 90) received olaparib/TMZ for diagnoses of IDH-mutant oligodendroglioma (n = 5), IDH-mutant astrocytoma grade 2–3 (n = 4), IDH-mutant astrocytoma grade 4 (n = 7), or IDH-wildtype glioma (n = 4). One patient was treated upfront and 19 at recurrence (median = 3). Olaparib 150 mg was administered 3 times/week concurrent with TMZ 50–75 mg/m2 daily. Fatigue, gastrointestinal symptoms, and hematologic toxicity were common. Six of 20 patients required dose reduction (n = 4) or discontinuation (n = 2) due to toxicity. Radiographic response was evaluable in 16 and observed (complete + partial) in 4/8 with IDH-mutant grade 2–3 glioma. No responses were seen in patients with grade 4 IDH-mutant astrocytomas (0/5) or IDH-wildtype gliomas (0/3). Progression-free survival was 7.8, 1.3, and 2.0 months, respectively.
Discussion Olaparib/TMZ resulted in objective radiographic response in 50% of evaluable patients with recurrent IDH-mutant grade 2–3 gliomas with encouraging progression-free survival and manageable toxicity. This supports a prospective trial of olaparib/TMZ for this population.
Classification of Evidence This case series provides Class IV evidence that treatment with olaparib/TMZ may result in radiographic response in patients with glioma.
Footnotes
Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
Submitted and externally peer reviewed. The handling editor was Rebecca Burch, MD.
Class of Evidence: NPub.org/coe
- Received March 22, 2022.
- Accepted in final form July 19, 2022.
- © 2022 American Academy of Neurology
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