An olaparib window-of-opportunity trial in patients with early-stage endometrial carcinoma: POLEN study

Gynecol Oncol. 2020 Dec;159(3):721-731. doi: 10.1016/j.ygyno.2020.09.013. Epub 2020 Sep 26.

Abstract

Objective: Olaparib is a potent inhibitor of poly(ADP-ribose) polymerase (PARP)-1, 2, and 3 with potential activity in endometrial cancer (EC).

Methods: In this window-of-opportunity trial, women with operable type 1 EC received olaparib oral tablets (300mg) twice daily for 28days before surgery. The primary objective was to evaluate the effects of olaparib on EC in tissue samples taken at baseline and at treatment completion. Signal of activity was defined as significant changes in the expression of the cell cycle-related proteins cyclin D1, Ki67, and cleaved caspase-3.

Results: A total of 31 patients were included in the biomarker analysis. The median time of olaparib exposure was 24 days (1-39). Significant inhibition was found for cyclin D1 (p < 0.01), but not for Ki67 and active caspase 3 immunostaining. PARP-1 levels positively correlated with cyclin D1 levels (rho = 0.661, p = 0.0001). Both PARP-1 and cyclin D1 levels were significantly lower (p = 0.022 and p = 0.004, respectively) in patients with ARID1A[-] tumors than ARID1A[+] tumors. A significant relationship between plasma olaparib concentrations and decreased GLUT1 activity was observed (r = -0.5885; p < 0.05). Drug-related toxicity consisted mostly of gastrointestinal and grade 1 or 2 adverse events.

Conclusions: Olaparib reduced expression of cyclin D1, which positively correlated with PARP-1 levels. This effect was more evident in ARID1A-deficient tumors. Olaparib further induced inhibition of GLUT1 plasma activity. Our findings could have noteworthy implications in predicting which patients with EC would benefit from olaparib-based strategies.

Keywords: Corpus uteri cancer; Endometrioid carcinoma; Olaparib; PARP inhibitor; Type I endometrial carcinoma.

Publication types

  • Multicenter Study
  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Oral
  • Adult
  • Aged
  • Aged, 80 and over
  • Biomarkers, Tumor / analysis*
  • Biomarkers, Tumor / genetics
  • Chemotherapy, Adjuvant / methods
  • Cyclin D1 / analysis
  • Cyclin D1 / genetics
  • DNA-Binding Proteins / genetics
  • Dose-Response Relationship, Drug
  • Endometrial Neoplasms / blood
  • Endometrial Neoplasms / diagnosis
  • Endometrial Neoplasms / genetics
  • Endometrial Neoplasms / therapy*
  • Endometrium / drug effects
  • Endometrium / pathology
  • Endometrium / surgery
  • Female
  • Gene Expression Regulation, Neoplastic / drug effects
  • Glucose Transporter Type 1 / antagonists & inhibitors
  • Glucose Transporter Type 1 / blood
  • Humans
  • Hysterectomy
  • Immunohistochemistry
  • Middle Aged
  • Neoadjuvant Therapy / methods*
  • Neoplasm Staging
  • Phthalazines / administration & dosage*
  • Phthalazines / adverse effects
  • Piperazines / administration & dosage*
  • Piperazines / adverse effects
  • Poly (ADP-Ribose) Polymerase-1 / antagonists & inhibitors
  • Poly (ADP-Ribose) Polymerase-1 / metabolism
  • Poly(ADP-ribose) Polymerase Inhibitors / administration & dosage*
  • Poly(ADP-ribose) Polymerase Inhibitors / adverse effects
  • Prospective Studies
  • Tablets
  • Time Factors
  • Transcription Factors / genetics
  • Treatment Outcome

Substances

  • ARID1A protein, human
  • Biomarkers, Tumor
  • CCND1 protein, human
  • DNA-Binding Proteins
  • Glucose Transporter Type 1
  • Phthalazines
  • Piperazines
  • Poly(ADP-ribose) Polymerase Inhibitors
  • SLC2A1 protein, human
  • Tablets
  • Transcription Factors
  • Cyclin D1
  • PARP1 protein, human
  • Poly (ADP-Ribose) Polymerase-1
  • olaparib