Dr. Macarulla Discusses Rapid Progressors in the POLO Trial

Teresa Macarulla, MD, a gastrointestinal medical oncologist at the Vall d’Hebron Institute of Oncology, discussed a new finding from the phase III POLO trial regarding patients who rapidly progressed on treatment presented at the 2020 Gastrointestinal Cancers Symposium.

The randomized, double-blind, placebo-controlled, POLO trial is evaluating the effectiveness of olaparib (Lynparza) as maintenance therapy in patients with germline BRCA1/2-mutated metastatic pancreatic cancer and disease that had not progressed during first-line platinum-based chemotherapy. Data published in the New England Journal of Medicine showed that the median progression-free survival (PFS) with olaparib was 7.4 months compared with 3.8 months with placebo in this patient population (HR, 0.53; 95% CI, 0.35-0.82; P = .004).

A percentage of patients in the POLO trial rapidly progress within the first 4 months after randomization to either olaparib or placebo, says Macarulla. The number of patients who can be considered as "rapid progressors" is not very high considering the limited number of patients assessed. It is also difficult to determine the clinical characteristics of the patients who rapidly progress on treatment, adds Macarulla. At the start of the trial, it was noted that the patients who presented with a worse performance status appeared to be more likely to progress rapidly, but no other observations were made, concludes Macarulla.

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