Introduction Maintenance Olaparib is approved for use after response to platinum-based chemotherapy in both first line and relapsed BRCA-mutated ovarian cancer. Here we present real world outcomes for women treated in a single institution.

Methods Between January 2017 and November 2019, data was collected retrospectively from patients with a germline or somatic BRCA mutation who received at least one cycle of Olaparib after > 4 cycles of platinum-based chemotherapy.

Results 53 patients were included in analysis (median age 60 years; 40 relapsed, 13 first line). In relapse, 14 (35%) continue on olaparib and 20 (50%) patients had died (median follow-up 21 months, range 8–42 months). Median progression free survival (PFS) was 13 months (95%CI 8.4–17.6 months). 5 patients had a PFS of over 2 years. Median overall survival (OS) was 24 months (95%CI 21.3–26.7 months). In first line, (median follow-up 12 months, range 8–16 months), 5 patients (38%) had progressed and 2 (15%) had died.

Overall, 27 patients (53%) required dose interruption (DI), and 36 (68%) required a dose reduction (DR). The most common reasons for DR were fatigue and anaemia (both 8 patients, 22%). One patient had grade 3 pneumonitis, one had a grade 4 allergic reaction, and one developed a secondary cancer (SCC of tongue) whilst on treatment.

Conclusions DR were more common in all patients and PFS and OS in the recurrent population was shorter in a real world population than in published trial data, but longer than in the placebo arm. Long term responders are seen.