How strict are you about adhering to the eligibility criteria required for entry onto the OlympiA trial in considering a year of adjuvant olaparib as adjuvant therapy for BRCA mutated, node positive, ER positive breast cancer?

Topics: Breast Cancer • Medical Oncology • HR+ • BRCA+ • Breast Cancer, Non-metastatic

If a patient had a CPS-EG of 2 after neoadjuvant therapy, would you offer that patient olaparib even though she wouldn't have met entry criteria? If this patient met criteria for adjuvant abemaciclib would you offer that instead?

Answer from: Medical Oncologist at Academic Institution

When considering PARP inhibitors or CDK4/6 inhibitors in the adjuvant setting, we follow the criteria used for the trials. This is because the trials dictated what is now in the guidelines and the guidelines dictate what insurance will cover.

Comments

Medical Oncologist at Alvin & Lois Lapidus Cancer Institute Northwest Hospital
If you could get coverage for olaparib in patients...

Answer from: Medical Oncologist at Academic Institution

I do offer adjuvant olaparib for patients with ER+ HER2-neg breast cancer beyond the eligibility in OlympiA. The bar for enrollment was very high for BRCA carriers with ER+ disease. So if a patient has 1-3 positive nodes, I do discuss and weigh other clinical factors.

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