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OLAPARIB – HOW BASIC RESEARCH LED TO A NEW CANCER TREATMENT

There is good news for women in the UK with ovarian cancer.

You may have caught the debate last year about whether the National Institute for Health Care and Excellence (NICE) would approve a brand new cancer drug, olaparib, for prescription on the NHS.

What is olaparib?

Olaparib is the first in a brand new class of cancer drug called PARP inhibitors. PARP inhibitors work by exploiting a defect some cancers have in a particular type of DNA repair. Because healthy cells don’t have this defect, olaparib is able to target and kill cancer cells more specifically than normal chemotherapy drugs can.

Olaparib was first licensed in late 2014 by the FDA in the USA, and by the EMA in Europe, for the treatment of advanced ovarian cancer. But olaparib is a costly drug. The question in the UK since then has been: will the NHS pay for it?

In December 2015 NICE released its final decision on olaparib. After initially saying ‘no’ earlier in the year, NICE softened its stance, thanks to an agreement with the manufacturer, AstraZeneca, on price.

Who will benefit?

Women with ovarian cancer who have had three rounds of conventional chemotherapy and who have a mutation in the BRCA1 or BRCA2 genes will be able to get olaparib. In clinical trials olaparib extended the progression-free survival of women with advanced ovarian cancer by an average of several months, and some women benefited much more than this. It will also be used to treat women with fallopian tube and peritoneal cancers.

How did Worldwide Cancer Research help?

In the mid-1990s we gave grants to Professor Steve Jackson in Cambridge for a series of projects studying DNA repair. He used findings from these projects, along with others, to set up a company called KuDOS Pharmaceuticals Ltd. Worldwide Cancer Research (or AICR as we were then) received shares in the company to recognise the contribution of our grants. KuDOS went on to develop olaparib, a drug targeting DNA repair – labelled ‘first in class’. KuDOS was taken over by AstraZeneca in 2005, at which point AstraZeneca took over testing of the drug.

Our story doesn’t stop there. Later, in the mid-2000s, we funded Professor Alan Clarke to test olaparib in a new mouse model of breast cancer. His work supported the case for using olaparib in cancers with BRCA mutations and helped olaparib on its way to clinical trials.

Dr Helen Rippon, Chief Executive, commented:

“We have been waiting for this news for months. Ovarian cancer lags behind other cancers when it comes to the availability of modern, targeted treatments, and the prognosis for women diagnosed with ovarian cancer is often poor. All cancer patients should be able to benefit from the most advanced treatments medicine has to offer; we are relieved that olaparib will finally be available on the NHS in the UK."

What next for olaparib?

You may have seen olaparib in the news again last autumn when promising findings were announced from a clinical trial in prostate cancer. And in January 2016 olaparib received Breakthrough Therapy Designation from the US Food and Drug Administration (FDA). This means that they believe the drug shows good promise and will make a decision about whether to approve the drug for treatment of prostate cancer within 60 days.

Olaparib is also in clinical trials for a wide range of other cancer types, including breast cancer, stomach cancer and pancreatic cancer. Needless to say, we will be paying very close attention to the outcomes. And, as research progresses, we have every hope that in future, olaparib will prove to be useful in treating these other diseases as well.

(Image source: AstraZeneca PLC)

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