Introduction/Background Olaparib has been used both as the maintenance treatment and also monotherapy for patients with ovarian cancer in the past few years.

Methodology We reported two cases of erythema nodosum associated with the use of olaparib.

Results Both patients had germline BRCA mutations and were started on maintenance olaparib capsule 400 mg twice daily after complete response to platinum-based chemotherapy for recurrent ovarian cancer.

Case 1: A 54-year-old woman complained of bilateral ankle swelling and reddish nodules on her shins 3 months after starting olaparib. Physical examination showed tender, erythematous subcutaneous nodules on her anterior shins compatible with erythema nodosum. Olaparib dose was reduced to 200 mg twice daily and the erythema nodosum resolved spontaneously after 2 weeks. Similar skin lesions but of milder degree recurred after she resumed olaparib at 400 mg twice daily. Again, the lesions subsided within 2 weeks after dose reduction to 200 mg twice daily. The patient was then put on olaparib at 300 mg twice daily with no reappearance of the skin lesions. The patient had another recurrence of her ovarian cancer 17 months after olaparib treatment.

Case 2: A 51-year-old woman complained of erythematous skin nodules on her left lower limb one week after starting olaparib, and similar lesions occurred on her right lower limb 2 weeks later. Physical examination showed erythematous subcutaneous nodules compatible with erythematous nodosum. The dose of olaparib was reduced to 300 mg twice daily and the skin lesions resolved after 2 weeks. The patient continued with olaparib at 300 mg twice daily with no skin reaction but was found to have another recurrence 4 months after olaparib treatment.

Conclusion We reported two cases of erythema nodosum associated with the use of olaparib. Both of our patients had resolution of the skin lesions within 2 weeks after dose reduction and no other treatment was required.

Disclosure Dr. KY Tse has received travel grants/lecture honorarium from MSD, ZaiLab and AstraZeneca; and funding for a research project by Pfizer. Prof. HYS Ngan was invited as the expert speaker and received travel grants from Roche, MSD, ZaiLab and AstraZeneca.