Olaparib as the first-line maintenance therapy in advanced-stage epithelial ovarian cancer patients with BRCA mutations – Real-world experience from Taiwan

OBJECTIVE: Advanced epithelial ovarian cancer frequently recurs despite good response to first-line treatment, making maintenance therapy essential. Olaparib, a poly (ADP-ribose) polymerase (PARP) inhibitor, demonstrated significant benefit in BRCA-mutated disease in the SOLO-1 trial; however, real-world data from Taiwan remain limited. MATERIALS AND METHODS: We conducted a retrospective cohort study of patients with stage III/IV BRCA1/2-mutated epithelial ovarian cancer treated at Chang Gung Memorial Hospital, Linkou, between 2019 and 2025. Eligible patients achieved complete or partial response to first-line platinum-based chemotherapy and received olaparib. Primary endpoints were progression-free survival (PFS) and overall survival (OS), with adverse events (AEs) as the secondary endpoint. RESULTS: Forty-one patients were analyzed, with a median follow-up of 30.4 months. The estimated mean PFS was 55.0 months, with 12-month, 24-month, and 36-month PFS rates of 90.0%, 78.1%, and 61.5%, respectively. Median OS was not reached (mean OS 62.2 months). Patients with partial response had higher recurrence rates than those with complete response. The most common hematologic AE was anemia (73.2%), predominantly grade 1-2. Frequently reported non-hematologic AEs included nausea, vomiting, and poor appetite. Dose adjustments occurred in 51.2% of patients, yet more than 80% maintained ≥75% of the recommended dose. No patient discontinued olaparib due to AEs. CONCLUSION: In Taiwanese patients with BRCA-mutated advanced stage epithelial ovarian cancer, real-world use of olaparib as first-line maintenance therapy demonstrated effectiveness comparable to the SOLO-1 trial, with manageable toxicity.