Clinical Efficacy of Olaparib in IDH1/IDH2- Mutant Mesenchymal Sarcomas

JCO Precis Oncol. 2021 Nov:5:466-472. doi: 10.1200/PO.20.00247.

Abstract

Purpose: Tumors with neomorphic mutations in IDH1/2 have defective homologous recombination repair, resulting in sensitivity to poly (ADP-ribose) polymerase (PARP) inhibition. The Olaparib Combination trial is a phase II, open-label study in which patients with solid tumors harboring IDH1/2 mutations were treated with olaparib as monotherapy, with objective response and clinical benefit rates as the primary end points.

Methods: Ten patients with IDH1/2-mutant tumors by next-generation sequencing were treated with olaparib 300 mg twice daily.

Results: Three of five patients with chondrosarcomas had clinical benefit, including one patient with a partial response and two with stable disease lasting > 7 months. A patient with pulmonary epithelioid hemangioendothelioma had stable disease lasting 11 months. In contrast, clinical benefit was not observed among four patients with cholangiocarcinoma.

Conclusion: These results indicate preliminary activity of PARP inhibition in patients with IDH1/2-mutant chondrosarcoma and pulmonary epithelioid hemangioendothelioma. Further studies of PARP inhibitors alone and in combination in this patient population are warranted.

Publication types

  • Clinical Trial, Phase II
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cholangiocarcinoma / drug therapy
  • Chondrosarcoma, Mesenchymal / drug therapy*
  • Chondrosarcoma, Mesenchymal / genetics*
  • Female
  • Hemangioendothelioma, Epithelioid / drug therapy
  • Humans
  • Isocitrate Dehydrogenase / genetics*
  • Lung Neoplasms / drug therapy
  • Male
  • Middle Aged
  • Mutation
  • Phthalazines / adverse effects
  • Phthalazines / therapeutic use*
  • Piperazines / adverse effects
  • Piperazines / therapeutic use*
  • Poly(ADP-ribose) Polymerase Inhibitors / adverse effects
  • Poly(ADP-ribose) Polymerase Inhibitors / therapeutic use*
  • Treatment Outcome

Substances

  • Phthalazines
  • Piperazines
  • Poly(ADP-ribose) Polymerase Inhibitors
  • IDH2 protein, human
  • Isocitrate Dehydrogenase
  • IDH1 protein, human
  • olaparib