Olaparib

What is olaparib?

Olaparib (Lynparza^®) is a type of targeted drug called a PARP inhibitor. A targeted drug is a type of medication that finds and stops processes in cancer cells that helps them to repair and grow.

PARP is a protein found in our cells and it helps to repair damaged DNA. Olaparib works by blocking the effect of PARP. Without PARP, the damaged DNA can't be repaired and the prostate cancer cells are more likely to die.

It is used to treat men whose cancer has spread from the prostate to other parts of the body (advanced or metastatic prostate cancer) that has stopped responding to hormone therapy  Olaparib won’t cure your prostate cancer, but it can help keep it under control and has been shown to help some men live longer.

Who can have olaparib?

Olaparib is a treatment for men with advanced prostate cancer that has stopped responding to hormone therapy. You may hear this called hormone-relapsed or castrate-resistant prostate cancer. This means your cancer is growing, even though your testosterone levels are being kept low by hormone therapies such as injections, implants, tablets or surgery to remove the testicles (orchidectomy).

There are two ways olaparib may be used in the treatment of advanced prostate cancer: 

• Alongside a type of hormone therapy called abiraterone and a steroid such as prednisolone. This would be an option if you are not suitable for or do not want chemotherapy. You would not have had androgen receptor pathway inhibitors (ARPi) hormone therapy such as abiraterone or enzalutamide before, or you must have stopped having an ARPi for more than 12 months.
• On its own (monotherapy). Olaparib can be used on its own if you have advanced prostate cancer that has stopped responding to hormone therapy and you have a BRCA1 or BRCA2 gene mutation. You would have already had an androgen receptor pathway inhibitor (ARPi) such as abiraterone or enzalutamide before using olaparib. You can have olaparib whether or not you have had chemotherapy before. 

What are BRCA1 and BRCA2?

BRCA1 and BRCA2 are two genes that everyone has. These genes are passed down from your parents (inherited). The function of the BRCA genes is in DNA repair and keeps healthy cells growing normally and prevent the growth of cancer cells.

In some people, these genes change and don’t work properly – this is called a gene mutation. Men with a BRCA1 or BRCA2 gene mutation have a higher risk of prostate cancer. Your body can create these gene mutations over time (somatic) or they can be inherited (germline).

Prostate cancer cells with a BRCA1 or BRCA2 mutation need PARP to repair. Olaparib blocks PARP, which makes it harder for cancer cells to live and grow. This means the cancer cells are more likely to die.

How do I know if I have a BRCA1 or BRCA2 gene mutation?

You may already know you have an inherited BRCA1 or BRCA2 gene mutation. If you have a family history of certain cancer, you may have already had a test to look for changes in your genes (genetic test).

If you don’t know if you have a BRCA mutation, speak to your hospital doctor, they may refer you for genetic testing.

If you are suitable, a genetic test will look at your genes using a sample of your cancer that’s already been taken. In some cases, this is done using a blood sample.

Talk to your doctor or nurse about BRCA1 and BRCA2, and whether you’re suitable for olaparib treatment. The NHS website has further information on genetic testing and genetic counselling.

Other health problems and medicines

Tell your doctor about any other health problems you have. You should also tell them about any other medicines you are taking or have taken recently. This includes any medicines taken without a prescription and herbal medicines. This is because olaparib might affect how some other medicines work. And some other medicines might affect how well olaparib works. After discussing about your health problems and other medications, your doctor will then be able to help you understand if olaparib is a treatment option for you.

If you have problems with your kidneys, your doctor may change the amount of olaparib (dose) you take. 

Other treatment options

If olaparib isn’t suitable for you, or if you choose not to have it, there may be other treatment options available. Read more about other treatment options for advanced prostate cancer or speak to your hospital medical team. They can also tell you about any clinical trials that might be suitable for you.

What does olaparib treatment involve?

Olaparib is usually taken as two tablets in the morning and two tablets in the evening. You should swallow the tablets whole with water. The tablets can be taken with or without food.

If you are having hormone therapy, you will continue having it at the same time as your olaparib treatment, even if its stopped working unless you have had surgery to remove the testicles.

You should not drink grapefruit juice while taking olaparib as it can affect the way the medicine works.

If you feel tired, weak or dizzy, don't drive or operate machinery.

How long will my treatment last?

You will have olaparib until it stops working or if you get severe side effects.

You will have regular hospital appointments while taking olaparib to check how well your treatment is working. How often you will have these appointments will depend on your hospital. You will probably have one hospital appointment every 2-4 weeks during the first year of treatment. After the first year, you will probably have hospital appointments every three months.

At these appointments, you will have several tests. What tests you have, and how often you have them will depend on your hospital. Your healthcare team will discuss this with you. They may include:

• a prostate specific antigen (PSA) blood test
• blood tests to check for anaemia or any problems with your immune system, kidneys or liver
• blood pressure tests
• scans such as MRI, CT or bone scans.

Your doctor will talk to you about your test results and any changes to your treatment.

What are the side effects?

Like all treatments, olaparib can cause side effects. These affect each person differently, and you’re unlikely to get all the possible side effects.

Before you start treatment, your hospital healthcare team will explain the possible side effects. Knowing what to expect can help you deal with them.

You can find out more information in the leaflet that comes with your medicine or on the Electronic Medicines Compendium (emc) website.

The most common side effects may include:

• anaemia
• feeling and being sick
• extreme tiredness (fatigue)
• indigestion or heartburn
• loss of appetite
• headache
• changes in the taste of food
• feeling dizzy
• cough
• shortness of breath
• diarrhoea.

Less common side effects:

Olaparib may increase your risk of getting another type of cancer called leukaemia (blood cancer), but this is rare.

If you have any side effects from taking olaparib, even if they’re not listed here or you have any worries, speak to your healthcare team as soon as possible. They may offer you other treatments to help you manage any side effects. 

Contraception

It is not known whether small amounts of olaparib are passed on through semen. Your doctor or nurse may advise you to wear a condom during olaparib treatment.  

If there is a chance your partner could become pregnant, you and your partner must use contraception when having sex. You should use a condom and your partner use another suitable method of contraception while you are taking olaparib and for the next three months after taking your last dose.   

If your partner is pregnant, you must use a condom when having sex while you are taking olaparib and for three months after taking your last dose. This is because olaparib may harm the baby.   

You must not donate sperm while taking olaparib and for 3 months after taking your last dose.  

If you have any questions around having sex while on olaparib, speak to your doctor or nurse.  

Dealing with prostate cancer

Being diagnosed and living with prostate cancer can change how you think and feel about life. If you or your loved one is dealing with prostate cancer, it's normal to feel scared, stressed or even angry. Lots of men with prostate cancer can get these kinds of thoughts and feelings. But there is no ‘right’ way to feel, and everyone reacts in their own way. You may find it helpful to read our information on living with advanced prostate cancer. Also, our wellbeing hub has information to help support you in looking after your emotional, mental, and physical wellbeing.

If you are close to someone with prostate cancer, find out more about how you can support someone with prostate cancer and where to get more information.

Questions you may want to ask your doctor or nurse

• Is olaparib a suitable treatment for me, and why?
• How do I know if I have a BRCA1 or BRCA2 gene mutation?
• If I get any side effects, are there ways I can manage them?
• If I have olaparib, what tests will I have to monitor my prostate cancer, and how often will I have them?
• Will I have other treatments alongside olaparib?
• What will happen if olaparib stops working?
• If I have an inherited mutation, what do I need to do?
• If I have a BRCA mutation, what does it mean for my children and other family members?

References

Last reviewed: September 2024 | Due for review: September 2027