Lynparza

— THERAPEUTIC CATEGORIES —
  • Breast cancer
  • Gynecologic cancers
  • Pancreatic, thyroid, and other endocrine cancers
  • Prostate and other male cancers

Lynparza Generic Name & Formulations

General Description

Olaparib 100mg, 150mg; tabs.

Pharmacological Class

Poly (ADP-ribose) polymerase (PARP) inhibitor.

See Also

    How Supplied

    Tabs—60, 120

    Generic Availability

    NO

    Mechanism of Action

    Olaparib is an inhibitor of poly (ADP-ribose) polymerase (PARP) enzymes, including PARP1, PARP2, and PARP3. In vitro studies have shown that olaparib-induced cytotoxicity may involve inhibition of PARP enzymatic activity and increased formation of PARP-DNA complexes, resulting in DNA damage and cancer cell death.

    Lynparza Indications

    Indications

    Adjuvant treatment of deleterious or suspected deleterious germline BRCA-mutated, HER2-negative high risk early breast cancer in adults who have been treated with neoadjuvant or adjuvant chemotherapy (as detected by an FDA-approved test). Treatment of deleterious or suspected deleterious germline BRCA-mutated, HER2-negative metastatic breast cancer in adults who have been treated with chemotherapy in the neoadjuvant, adjuvant, or metastatic setting (as detected by an FDA-approved test). Patients with HR-positive breast cancer should have been treated with prior endocrine therapy or be considered inappropriate for endocrine therapy.

    Lynparza Dosage and Administration

    Adult

    Swallow whole. 300mg twice daily. Early breast cancer: continue for a total of 1yr, or until disease recurrence or unacceptable toxicity. Metastatic breast cancer: continue until disease progression or unacceptable toxicity. Dose adjustments for adverse reactions: reduce to 250mg twice daily; may further reduce to 200mg twice daily. Concomitant strong or moderate CYP3A inhibitors (if unavoidable): reduce olaparib dose to 100mg twice daily (with strong inhibitors) or 150mg twice daily (with moderate inhibitors). Moderate renal impairment (CrCl 31–50mL/min): reduce to 200mg twice daily.

    Children

    Not established.

    Lynparza Contraindications

    Not Applicable

    Lynparza Boxed Warnings

    Not Applicable

    Lynparza Warnings/Precautions

    Warnings/Precautions

    Do not start therapy until recovery from hematological toxicity due to previous chemotherapy (CTCAE Grade ≤1). Monitor CBC for cytopenia at baseline and monthly thereafter during therapy or weekly until recovery (for prolonged hematological toxicities). Discontinue if myelodysplastic syndrome/acute myeloid leukemia (MDS/AML) is confirmed. Interrupt therapy and evaluate if new or worsening respiratory symptoms occur; discontinue and treat if pneumonitis is confirmed. Monitor for venous thrombosis, pulmonary embolism; treat appropriately. Mild renal impairment: monitor closely. Severe hepatic or severe renal impairment or ESRD (CrCl ≤30mL/min): not studied. Embryo-fetal toxicity. Advise females of reproductive potential to use effective contraception during and for 6 months after the last dose. Males (w. female partners) should use effective contraception and do not donate sperm during and for 3 months after the last dose. Pregnancy: exclude status prior to initiation. Nursing mothers: not recommended (during and for 1 month after the last dose).

    Lynparza Pharmacokinetics

    Absorption

    Median time to peak plasma concentration: 1.5 hours.

    Distribution

    Mean apparent volume of distribution: 158 ± 136 L.

    Plasma protein bound: ~82% (in vitro).

    Metabolism

    CYP3A4.

    Elimination

    Renal (44%), fecal (42%). Half-life: 14.9 ± 8.2 hours.

    Lynparza Interactions

    Interactions

    Increased myelosuppressive toxicity with concomitant other myelosuppressive anticancer agents, including DNA damaging agents. Avoid concomitant strong CYP3A inhibitors (eg, itraconazole) and moderate CYP3A inhibitors (eg, fluconazole); if unavoidable, reduce dose (see Adults). Avoid grapefruit, grapefruit juice, Seville oranges, and Seville orange juice. Avoid concomitant strong CYP3A inducers (eg, rifampicin) and moderate CYP3A inducers (eg, efavirenz); if unavoidable, be aware of potential for decreased efficacy.

    Lynparza Adverse Reactions

    Adverse Reactions

    Nausea, fatigue, asthenia, anemia, vomiting, diarrhea, decreased appetite, headache, neutropenia, dysgeusia, cough, dyspnea, dizziness, dyspepsia, leukopenia, thrombocytopenia, upper abdominal pain. In combination with bevacizumab or abiraterone and prednisone or prednisolone: also lymphopenia, UTI.

    Lynparza Clinical Trials

    See Literature

    Lynparza Note

    Not Applicable

    Lynparza Patient Counseling

    See Literature

    Lynparza Generic Name & Formulations

    General Description

    Olaparib 100mg, 150mg; tabs.

    Pharmacological Class

    Poly (ADP-ribose) polymerase (PARP) inhibitor.

    See Also

      How Supplied

      Tabs—60, 120

      Generic Availability

      NO

      Mechanism of Action

      Olaparib is an inhibitor of poly (ADP-ribose) polymerase (PARP) enzymes, including PARP1, PARP2, and PARP3. In vitro studies have shown that olaparib-induced cytotoxicity may involve inhibition of PARP enzymatic activity and increased formation of PARP-DNA complexes, resulting in DNA damage and cancer cell death.

      Lynparza Indications

      Indications

      First-line maintenance treatment of deleterious or suspected deleterious germline or somatic BRCA-mutated advanced epithelial ovarian, fallopian tube or primary peritoneal cancer, in adults who are in complete or partial response to first-line platinum-based chemotherapy (as detected by an FDA-approved test). In combination with bevacizumab for the first-line maintenance treatment of advanced epithelial ovarian, fallopian tube or primary peritoneal cancer, in adults who are in complete or partial response to first-line platinum-based chemotherapy and whose cancer is associated with homologous recombination deficiency (HRD)-positive status defined by either a deleterious or suspected deleterious BRCA mutation, and/or genomic instability (as detected by an FDA-approved test). Maintenance treatment of deleterious or suspected deleterious germline or somatic BRCA-mutated recurrent epithelial ovarian, fallopian tube or primary peritoneal cancer, in adults who are in complete or partial response to platinum-based chemotherapy (as detected by an FDA-approved test).

      Lynparza Dosage and Administration

      Adult

      Swallow whole. 300mg twice daily. First-line maintenance of BRCA-mutated or HRD-positive advanced ovarian: continue until disease progression, unacceptable toxicity, or completion of 2yrs of treatment. Discontinue if complete response at 2yrs; may treat beyond 2yrs in those with evidence of disease if provider can derive further benefit from continuous treatment. Others: continue until disease progression or unacceptable toxicity. In combination with bevacizumab: give bevacizumab (15mg/kg every 3 weeks) for total of 15 months (refer to respective product labeling for details). Dose adjustments for adverse reactions: reduce to 250mg twice daily; may further reduce to 200mg twice daily. Concomitant strong or moderate CYP3A inhibitors (if unavoidable): reduce olaparib dose to 100mg twice daily (with strong inhibitors) or 150mg twice daily (with moderate inhibitors). Moderate renal impairment (CrCl 31–50mL/min): reduce to 200mg twice daily.

      Children

      Not established.

      Lynparza Contraindications

      Not Applicable

      Lynparza Boxed Warnings

      Not Applicable

      Lynparza Warnings/Precautions

      Warnings/Precautions

      Do not start therapy until recovery from hematological toxicity due to previous chemotherapy (CTCAE Grade ≤1). Monitor CBC for cytopenia at baseline and monthly thereafter during therapy or weekly until recovery (for prolonged hematological toxicities). Discontinue if myelodysplastic syndrome/acute myeloid leukemia (MDS/AML) is confirmed. Interrupt therapy and evaluate if new or worsening respiratory symptoms occur; discontinue and treat if pneumonitis is confirmed. Monitor for venous thrombosis, pulmonary embolism; treat appropriately. Mild renal impairment: monitor closely. Severe hepatic or severe renal impairment or ESRD (CrCl ≤30mL/min): not studied. Embryo-fetal toxicity. Advise females of reproductive potential to use effective contraception during and for 6 months after the last dose. Males (w. female partners) should use effective contraception and do not donate sperm during and for 3 months after the last dose. Pregnancy: exclude status prior to initiation. Nursing mothers: not recommended (during and for 1 month after the last dose).

      Lynparza Pharmacokinetics

      Absorption

      Median time to peak plasma concentration: 1.5 hours.

      Distribution

      Mean apparent volume of distribution: 158 ± 136 L.

      Plasma protein bound: ~82% (in vitro).

      Metabolism

      CYP3A4.

      Elimination

      Renal (44%), fecal (42%). Half-life: 14.9 ± 8.2 hours.

      Lynparza Interactions

      Interactions

      Increased myelosuppressive toxicity with concomitant other myelosuppressive anticancer agents, including DNA damaging agents. Avoid concomitant strong CYP3A inhibitors (eg, itraconazole) and moderate CYP3A inhibitors (eg, fluconazole); if unavoidable, reduce dose (see Adults). Avoid grapefruit, grapefruit juice, Seville oranges, and Seville orange juice. Avoid concomitant strong CYP3A inducers (eg, rifampicin) and moderate CYP3A inducers (eg, efavirenz); if unavoidable, be aware of potential for decreased efficacy.

      Lynparza Adverse Reactions

      Adverse Reactions

      Nausea, fatigue, asthenia, anemia, vomiting, diarrhea, decreased appetite, headache, neutropenia, dysgeusia, cough, dyspnea, dizziness, dyspepsia, leukopenia, thrombocytopenia, upper abdominal pain. In combination with bevacizumab or abiraterone and prednisone or prednisolone: also lymphopenia, UTI.

      Lynparza Clinical Trials

      See Literature

      Lynparza Note

      Not Applicable

      Lynparza Patient Counseling

      See Literature

      Lynparza Generic Name & Formulations

      General Description

      Olaparib 100mg, 150mg; tabs.

      Pharmacological Class

      Poly (ADP-ribose) polymerase (PARP) inhibitor.

      See Also

        How Supplied

        Tabs—60, 120

        Generic Availability

        NO

        Mechanism of Action

        Olaparib is an inhibitor of poly (ADP-ribose) polymerase (PARP) enzymes, including PARP1, PARP2, and PARP3. In vitro studies have shown that olaparib-induced cytotoxicity may involve inhibition of PARP enzymatic activity and increased formation of PARP-DNA complexes, resulting in DNA damage and cancer cell death.

        Lynparza Indications

        Indications

        First-line maintenance treatment of deleterious or suspected deleterious germline BRCA-mutated metastatic pancreatic adenocarcinoma in adults whose disease has not progressed on at least 16 weeks of a first-line platinum-based chemotherapy regimen (as detected by an FDA-approved test).

        Lynparza Dosage and Administration

        Adult

        Swallow whole. 300mg twice daily. Continue until disease progression or unacceptable toxicity. Dose adjustments for adverse reactions: reduce to 250mg twice daily; may further reduce to 200mg twice daily. Concomitant strong or moderate CYP3A inhibitors (if unavoidable): reduce olaparib dose to 100mg twice daily (with strong inhibitors) or 150mg twice daily (with moderate inhibitors). Moderate renal impairment (CrCl 31–50mL/min): reduce to 200mg twice daily.

        Children

        Not established.

        Lynparza Contraindications

        Not Applicable

        Lynparza Boxed Warnings

        Not Applicable

        Lynparza Warnings/Precautions

        Warnings/Precautions

        Do not start therapy until recovery from hematological toxicity due to previous chemotherapy (CTCAE Grade ≤1). Monitor CBC for cytopenia at baseline and monthly thereafter during therapy or weekly until recovery (for prolonged hematological toxicities). Discontinue if myelodysplastic syndrome/acute myeloid leukemia (MDS/AML) is confirmed. Interrupt therapy and evaluate if new or worsening respiratory symptoms occur; discontinue and treat if pneumonitis is confirmed. Monitor for venous thrombosis, pulmonary embolism; treat appropriately. Mild renal impairment: monitor closely. Severe hepatic or severe renal impairment or ESRD (CrCl ≤30mL/min): not studied. Embryo-fetal toxicity. Advise females of reproductive potential to use effective contraception during and for 6 months after the last dose. Males (w. female partners) should use effective contraception and do not donate sperm during and for 3 months after the last dose. Pregnancy: exclude status prior to initiation. Nursing mothers: not recommended (during and for 1 month after the last dose).

        Lynparza Pharmacokinetics

        Absorption

        Median time to peak plasma concentration: 1.5 hours.

        Distribution

        Mean apparent volume of distribution: 158 ± 136 L.

        Plasma protein bound: ~82% (in vitro).

        Metabolism

        CYP3A4.

        Elimination

        Renal (44%), fecal (42%). Half-life: 14.9 ± 8.2 hours.

        Lynparza Interactions

        Interactions

        Increased myelosuppressive toxicity with concomitant other myelosuppressive anticancer agents, including DNA damaging agents. Avoid concomitant strong CYP3A inhibitors (eg, itraconazole) and moderate CYP3A inhibitors (eg, fluconazole); if unavoidable, reduce dose (see Adults). Avoid grapefruit, grapefruit juice, Seville oranges, and Seville orange juice. Avoid concomitant strong CYP3A inducers (eg, rifampicin) and moderate CYP3A inducers (eg, efavirenz); if unavoidable, be aware of potential for decreased efficacy.

        Lynparza Adverse Reactions

        Adverse Reactions

        Nausea, fatigue, asthenia, anemia, vomiting, diarrhea, decreased appetite, headache, neutropenia, dysgeusia, cough, dyspnea, dizziness, dyspepsia, leukopenia, thrombocytopenia, upper abdominal pain. In combination with bevacizumab or abiraterone and prednisone or prednisolone: also lymphopenia, UTI.

        Lynparza Clinical Trials

        See Literature

        Lynparza Note

        Not Applicable

        Lynparza Patient Counseling

        See Literature

        Lynparza Generic Name & Formulations

        General Description

        Olaparib 100mg, 150mg; tabs.

        Pharmacological Class

        Poly (ADP-ribose) polymerase (PARP) inhibitor.

        See Also

          How Supplied

          Tabs—60, 120

          Generic Availability

          NO

          Mechanism of Action

          Olaparib is an inhibitor of poly (ADP-ribose) polymerase (PARP) enzymes, including PARP1, PARP2, and PARP3. In vitro studies have shown that olaparib-induced cytotoxicity may involve inhibition of PARP enzymatic activity and increased formation of PARP-DNA complexes, resulting in DNA damage and cancer cell death.

          Lynparza Indications

          Indications

          Treatment of deleterious or suspected deleterious germline or somatic homologous recombination repair (HRR) gene-mutated metastatic castration-resistant prostate cancer (mCRPC) in adults who have progressed following prior treatment with enzalutamide or abiraterone (as detected by an FDA-approved test). In combination with abiraterone and prednisone or prednisolone for the treatment of deleterious or suspected deleterious BRCA-mutated (BRCAm) mCRPC in adults (as detected by an FDA-approved test).

          Lynparza Dosage and Administration

          Adult

          Swallow whole. 300mg twice daily. Continue until disease progression or unacceptable toxicity. Should also give a GnRH analog concurrently or should have had bilateral orchiectomy. For BRCAm mCRPC: give abiraterone 1000mg once daily with prednisone or prednisolone 5mg twice daily. Dose adjustments for adverse reactions: reduce to 250mg twice daily; may further reduce to 200mg twice daily. Concomitant strong or moderate CYP3A inhibitors (if unavoidable): reduce olaparib dose to 100mg twice daily (with strong inhibitors) or 150mg twice daily (with moderate inhibitors). Moderate renal impairment (CrCl 31–50mL/min): reduce to 200mg twice daily.

          Children

          Not established.

          Lynparza Contraindications

          Not Applicable

          Lynparza Boxed Warnings

          Not Applicable

          Lynparza Warnings/Precautions

          Warnings/Precautions

          Do not start therapy until recovery from hematological toxicity due to previous chemotherapy (CTCAE Grade ≤1). Monitor CBC for cytopenia at baseline and monthly thereafter during therapy or weekly until recovery (for prolonged hematological toxicities). Discontinue if myelodysplastic syndrome/acute myeloid leukemia (MDS/AML) is confirmed. Interrupt therapy and evaluate if new or worsening respiratory symptoms occur; discontinue and treat if pneumonitis is confirmed. Monitor for venous thrombosis, pulmonary embolism; treat appropriately. Mild renal impairment: monitor closely. Severe hepatic or severe renal impairment or ESRD (CrCl ≤30mL/min): not studied. Embryo-fetal toxicity. Advise females of reproductive potential to use effective contraception during and for 6 months after the last dose. Males (w. female partners) should use effective contraception and do not donate sperm during and for 3 months after the last dose. Pregnancy: exclude status prior to initiation. Nursing mothers: not recommended (during and for 1 month after the last dose).

          Lynparza Pharmacokinetics

          Absorption

          Median time to peak plasma concentration: 1.5 hours.

          Distribution

          Mean apparent volume of distribution: 158 ± 136 L.

          Plasma protein bound: ~82% (in vitro).

          Metabolism

          CYP3A4.

          Elimination

          Renal (44%), fecal (42%). Half-life: 14.9 ± 8.2 hours.

          Lynparza Interactions

          Interactions

          Increased myelosuppressive toxicity with concomitant other myelosuppressive anticancer agents, including DNA damaging agents. Avoid concomitant strong CYP3A inhibitors (eg, itraconazole) and moderate CYP3A inhibitors (eg, fluconazole); if unavoidable, reduce dose (see Adults). Avoid grapefruit, grapefruit juice, Seville oranges, and Seville orange juice. Avoid concomitant strong CYP3A inducers (eg, rifampicin) and moderate CYP3A inducers (eg, efavirenz); if unavoidable, be aware of potential for decreased efficacy.

          Lynparza Adverse Reactions

          Adverse Reactions

          Nausea, fatigue, asthenia, anemia, vomiting, diarrhea, decreased appetite, headache, neutropenia, dysgeusia, cough, dyspnea, dizziness, dyspepsia, leukopenia, thrombocytopenia, upper abdominal pain. In combination with bevacizumab or abiraterone and prednisone or prednisolone: also lymphopenia, UTI.

          Lynparza Clinical Trials

          See Literature

          Lynparza Note

          Not Applicable

          Lynparza Patient Counseling

          See Literature