Olaparib

What is olaparib?

Olaparib (Lynparza®) is a type of drug used to treat men who are known to have a BRCA1 or BRCA2 gene change (mutation), and whose prostate cancer has stopped responding to hormone therapy. It’s only suitable for some men with prostate cancer that has spread to other parts of the body (advanced prostate cancer).

Prostate cancer cells with a BRCA1 or BRCA2 mutation need a protein called PARP 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. 

Olaparib won’t cure your prostate cancer. But it 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 therapy or surgery to remove the testicles (orchidectomy).

Olaparib will only be an option if you’ve already had abiraterone or enzalutamide as part of your hormone therapy treatment.

Olaparib will also only be an option if you’re known to have a BRCA1 or BRCA2 gene change (mutation). If you don’t have BRCA1 or BRCA2 gene mutation, olaparib won’t be an option for you. Your doctor will talk to you about other treatments for your advanced prostate cancer.

What are BRCA1 and BRCA2?

BRCA1 and BRCA2 are two genes that everyone has. These genes are passed down from a parent (inherited). The function of the BRCA genes is to keep 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 or they can be inherited.

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

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

You may already know you have a 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. Your doctor will talk to you about whether olaparib is suitable 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 are 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 so well.

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

You may experience side effects while taking olaparib that could affect your ability to drive or operate machinery. Do not drive or operate machinery if you feel tired, weak or dizzy.

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 a month for 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 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.

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

Contraception

If there is a chance your partner could become pregnant, you must use contraception when having sex. Use a condom and a second method of contraception while you are taking olaparib and for three months after.

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

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

There is no evidence that having unprotected sex while you are taking olaparib will harm your partner. But if you or your partner are worried about this, it’s best to use a condom until you stop your treatment.

Dealing with prostate cancer

Being diagnosed and living with prostate cancer can change how you feel about life. If you or your loved one is dealing with prostate cancer you may feel scared, stressed or even angry. There is no ‘right’ way to feel and everyone reacts differently. 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?

References

Created: December 2021 | To reviewed: June 2024