ESMO 2018: Neoadjuvant Olaparib in Squamous Cell Head and Neck Carcinoma
Posted: Tuesday, November 20, 2018
According to the early results of the OPHELIA trial, neoadjuvant olaparib treatment seems to be well tolerated and to elicit antitumor responses in patients with squamous cell head and neck—with or without cisplatin. Amanda Psyrri, MD, PhD, and colleagues, of the University General Hospital Attikon, Athens, believe that the higher levels of spontaneous ongoing DNA damage noted in this patient population compared with controls “may serve as a candidate biomarker for response to immunotherapy in head and neck squamous cell carcinoma.” These findings were presented at the European Society for Medical Oncology (ESMO) 2018 Congress in Munich (Abstract 1045O).
In this ongoing phase II, window-of-opportunity, open-label, randomized trial, 23 patients with treatment-naive operable squamous cell carcinoma of the oral cavity, oropharynx, hypopharynx, or larynx have been enrolled so far. Of them, 12 patients were randomly assigned to receive olaparib alone, 8 patients received olaparib and cisplatin, and 3 patients received no treatment.
The investigators reported that 17% of these patients (3 in the olaparib arm and 1 in the olaparib-plus-cisplatin arm) had clinical or pathologic downstaging of disease, with 1 patient achieving a pathologic complete response. Of note, higher levels of ongoing spontaneous DNA damage were seen in the peripheral blood mononuclear cell samples of untreated patients versus healthy patients. Ex vivo analysis showed that healthy patients seemed more able to repair cisplatin-induced DNA damage (by removal of monoadducts) than were untreated patients. No serious treatment-related adverse events or delays to surgery have been reported thus far.