Olaparib (Lynparza)
Oral PARP inhibitor for BRCA/HRD-mutated ovarian, breast, prostate, and pancreatic cancers.
What is Olaparib (Lynparza)?
What it targets
Blocks PARP1 and PARP2 enzymes that repair single-strand DNA breaks, causing lethal DNA damage accumulation in tumours with BRCA or HRR repair defects.
Who it may help
Patients with BRCA-mutated or HRD-positive ovarian, breast, prostate, or pancreatic cancers meeting indication-specific eligibility and biomarker criteria.
Why testing matters
BRCA, HRD, or HRR gene testing is required before prescribing olaparib - without confirmed biomarker status, olaparib cannot be appropriately used.
Which cancers can Olaparib treat?
Olaparib is approved for four cancer types, each with specific biomarker requirements and treatment-line criteria.
| Ovarian cancer (maintenance) | FDA and EMA approved as maintenance therapy in BRCA-mutated advanced ovarian, fallopian tube, or primary peritoneal cancer after platinum chemotherapy response. Also approved with bevacizumab in HRD-positive advanced disease maintenance settings. |
| Breast cancer (adjuvant and metastatic) | Approved for adjuvant treatment in high-risk germline BRCA-mutated HER2-negative early breast cancer, and for germline BRCA-mutated HER2-negative metastatic breast cancer in later-line settings based on OlympiA and OlympiAD trial data. |
| Prostate cancer (mCRPC) | Approved for HRR or BRCA-mutated metastatic castration-resistant prostate cancer - as monotherapy in BRCA-mutated disease and in combination with abiraterone plus prednisone in selected mCRPC settings based on PROfound and PROpel trials. |
| Pancreatic cancer (maintenance) | Approved as maintenance therapy in germline BRCA-mutated metastatic pancreatic adenocarcinoma that has not progressed on first-line platinum-based chemotherapy, based on the POLO trial. |
Are you eligible for Olaparib?
Eligibility depends on confirmed biomarker status, cancer type, treatment line, and organ function. Always confirm with your treating oncologist.
- Confirmed BRCA1 or BRCA2 mutation (germline or somatic) by approved companion diagnostic testing - required for most olaparib indications.
- HRD-positive tumour status confirmed by an approved test - required for olaparib plus bevacizumab in HRD-positive advanced ovarian cancer maintenance.
- HRR gene alteration confirmed by validated tumour testing - required for certain metastatic castration-resistant prostate cancer settings.
- Correct cancer type and treatment line - olaparib approval is indication-specific and depends on prior treatment history.
- Adequate baseline blood counts - hemoglobin, neutrophil count, and platelets must meet minimum thresholds before starting treatment.
- Adequate kidney function - creatinine clearance is checked to determine the correct dose; dose reduction is needed for moderate renal impairment.
- Adequate liver function - liver enzyme levels are assessed at baseline and monitored during treatment.
- No pregnancy at baseline - highly effective contraception is required during treatment and for a defined period after the last dose.
How does Olaparib work?
- PARP enzyme inhibition
- DNA damage builds up in cancer cells
- Synthetic lethality - the key principle
- Tumour growth is controlled
Olaparib turns a cancer cell's own DNA repair defect against it - a concept known as synthetic lethality.
Tests required before starting Olaparib
These tests confirm eligibility, establish a safety baseline, guide dosing decisions, and allow accurate response monitoring during treatment.
| Germline BRCA1/BRCA2 testing | Blood or saliva sample tested in a clinical genetics laboratory. Detects inherited BRCA mutations. Required for most olaparib indications and used to counsel family members. |
| Somatic BRCA testing | Tumour tissue or liquid biopsy tested for BRCA mutations in the cancer cells themselves. Captures mutations not found on germline testing. May be required alongside or instead of germline testing in some settings. |
| HRD testing (ovarian cancer) | Approved HRD assay on tumour tissue confirms eligibility for olaparib plus bevacizumab in HRD-positive advanced ovarian cancer maintenance. Results take 1-3 weeks. |
| HRR gene panel (prostate cancer) | Validated HRR gene panel on tumour biopsy or blood confirms eligibility for olaparib in mCRPC settings. Covers BRCA1, BRCA2, ATM, CDK12, and other HRR genes. |
| Complete Blood Count (CBC) | Hemoglobin, white cell count, neutrophils, and platelets - must meet minimum thresholds before starting and are monitored throughout treatment. |
| Kidney function tests | Creatinine clearance (eGFR) - needed to determine the correct olaparib dose. Dose reduction to 200 mg twice daily is required for moderate renal impairment. |
| Liver function tests | ALT, AST, and bilirubin - assessed at baseline and monitored periodically. Severe liver impairment may affect olaparib tolerability. |
| Baseline imaging scan | CT or MRI scan to establish disease extent and tumour size before starting olaparib, allowing accurate comparison for later response assessment. |
| Pregnancy test | Mandatory for all patients of childbearing potential - result must be negative before the first dose of olaparib. |
| Medication review | Full list of all current medicines and supplements reviewed for CYP3A interactions before prescribing olaparib. |
How is Olaparib given?
Olaparib is taken orally at home as tablets, twice daily at approximately 12-hour intervals. No hospital infusion is needed.
| Standard dose | 300 mg (two 150 mg tablets) twice daily - the approved dose for most olaparib indications. |
| First dose reduction | 250 mg twice daily - used when side effects require a step-down from the 300 mg starting dose. |
| Second dose reduction | 200 mg twice daily - used if further dose reduction is needed for tolerability. Also the required dose for moderate renal impairment. |
| How to take | Tablets are swallowed whole with a full glass of water. Olaparib can be taken with or without food - consistent timing each day matters more than food intake. |
| Timing | Take at the same two times each day, approximately 12 hours apart, to maintain steady drug levels in the blood. |
| Missed dose | Take the missed dose the same day as soon as you remember. If the next scheduled dose is approaching, skip the missed dose and continue normally. Never take a double dose. |
| Duration of treatment | Continue until disease progression, unacceptable toxicity, or for the fixed adjuvant period in early breast cancer - as directed by your oncologist. |
| Do not stop without advice | Never stop olaparib without oncologist guidance. Unexpected interruptions may allow cancer to progress. |
Clinical evidence and benefits of Olaparib
Olaparib has established clinical benefits across multiple cancer types in biomarker-selected patient groups, supported by landmark randomised trials.
| SOLO-1 trial (ovarian cancer) | Substantially prolonged progression-free survival in BRCA-mutated advanced ovarian cancer as first-line maintenance therapy versus placebo, with a large proportion of patients remaining progression-free at 5 years. |
| PAOLA-1 trial (ovarian cancer) | Olaparib plus bevacizumab significantly extended progression-free survival in HRD-positive advanced ovarian cancer maintenance compared with bevacizumab alone. |
| OlympiA trial (early breast cancer) | Adjuvant olaparib meaningfully reduced the risk of disease recurrence or death in high-risk germline BRCA-mutated HER2-negative early breast cancer compared with placebo. |
| OlympiAD trial (metastatic breast cancer) | Olaparib improved progression-free survival and overall response rate in germline BRCA-mutated HER2-negative metastatic breast cancer versus standard chemotherapy. |
| PROfound trial (prostate cancer) | Olaparib substantially improved progression-free and overall survival in BRCA-mutated metastatic castration-resistant prostate cancer compared with enzalutamide or abiraterone. |
| POLO trial (pancreatic cancer) | Maintenance olaparib meaningfully extended progression-free survival in germline BRCA-mutated metastatic pancreatic cancer after platinum-based first-line chemotherapy. |
Individual responses vary widely. These outcomes represent published clinical trial data in biomarker-selected populations and may not reflect every patient's experience.
Side effects of Olaparib
Olaparib's side effect profile is different from traditional chemotherapy. Hair loss is not a typical side effect. The most common issues are fatigue, nausea, and blood count changes, which are usually manageable with supportive care and dose adjustment where needed.
| Fatigue or weakness | Very common - report severe or worsening fatigue promptly, as it can signal anemia or a more serious blood count change requiring review. |
| Nausea | Very common, especially in the first weeks of treatment. Usually improves over time. Anti-nausea medication can help if it affects daily life. |
| Anemia (low hemoglobin) | Common - monitored by regular CBC. May require dose interruption or reduction. Occasionally requires a blood transfusion if hemoglobin falls significantly. |
| Vomiting | Common - usually manageable with anti-nausea medication. Report persistent or severe vomiting to your oncology team promptly. |
| Diarrhea | Common - maintain adequate fluid intake. Report if severe, persistent, or accompanied by cramping. |
| Low neutrophil count (neutropenia) | Monitored by CBC. Severe neutropenia may require dose interruption and carries risk of infection - report any fever urgently. |
| Low platelet count (thrombocytopenia) | Monitored by regular CBC. Report any unusual bruising or unexplained bleeding to your team. |
| Loss of appetite | Common - nutritional support and meal planning guidance from your oncology team or a dietitian can help maintain adequate intake. |
| Headache or dizziness | Common - report if persistent, severe, or associated with very low blood pressure or blood counts. |
| Muscle or joint pain | Common - inform your oncologist if pain is significantly limiting daily activities, as dose adjustment may be considered. |
| Changes in taste | Common and usually temporary. Dietary adjustments such as cooler foods and flavour variety can help during treatment. |
Contact your doctor immediately if you develop:
- Worsening breathlessness or a new persistent cough - possible signs of pneumonitis (lung inflammation) requiring urgent assessment.
- Persistent very low blood counts or prolonged fatigue despite dose interruption - possible signs of MDS or AML.
- Fever, chills, or signs of infection - neutropenia raises infection risk and urgent review is needed.
- Leg pain, swelling, sudden chest pain, or shortness of breath - possible signs of venous thromboembolism (blood clots).
- Unusual bruising, prolonged bleeding, or severe fatigue - may indicate dangerous blood count changes needing immediate review.
Safety precautions and drug interactions
Tell your oncologist and pharmacist about all prescription medicines, over-the-counter drugs, supplements, and herbal products before starting olaparib.
- Strong CYP3A inhibitors (e.g., itraconazole, voriconazole, fluconazole) significantly increase olaparib blood levels - dose reduction may be required.
- Strong or moderate CYP3A inducers (e.g., rifampicin, carbamazepine, phenytoin) reduce olaparib effectiveness - avoid these medicines if possible.
- St. John's Wort is a CYP3A inducer and must be avoided during olaparib treatment - it can reduce drug levels to ineffective concentrations.
- Pregnancy is contraindicated - olaparib can cause fetal harm. Highly effective contraception is required during and for months after completing treatment.
- Breastfeeding is not recommended during olaparib treatment or for at least one month after the last dose.
- Pre-existing low blood counts - baseline CBC is essential; patients with bone marrow compromise need careful assessment before starting.
- Moderate renal impairment requires dose reduction to 200 mg twice daily. Severe renal impairment data are limited - oncologist assessment required.
- Live vaccines are not recommended during olaparib treatment - discuss all upcoming vaccinations with your oncologist before starting.
Olaparib combination treatments
Olaparib is used alone in several settings and in combination with other targeted agents in others, depending on cancer type, biomarker profile, and treatment line.
| Olaparib + bevacizumab (ovarian cancer) | Approved as first-line maintenance in HRD-positive advanced ovarian cancer after response to platinum-based chemotherapy that included bevacizumab. Based on PAOLA-1 trial results. |
| Olaparib + abiraterone + prednisone (prostate cancer) | FDA and EMA approved combination for metastatic castration-resistant prostate cancer. Based on PROpel trial results. Approved regardless of HRR status in some labelling. |
| Olaparib monotherapy - maintenance | Used alone as maintenance treatment in BRCA-mutated advanced ovarian cancer, BRCA-mutated metastatic pancreatic cancer, and BRCA-mutated mCRPC after prior therapy. |
| Olaparib adjuvant monotherapy (breast cancer) | Used alone for one year as adjuvant therapy in high-risk HER2-negative germline BRCA-mutated early breast cancer after standard chemotherapy, based on OlympiA. |
| Sequential approach with platinum chemotherapy | In metastatic pancreatic cancer, olaparib maintenance begins after at least 16 weeks of first-line platinum-based therapy in patients whose disease has not progressed. |
If Olaparib stops working
Resistance to olaparib can develop over time. Identifying the mechanism guides next-line treatment decisions and helps match patients to clinical trials.
| BRCA reversion mutations | Cancer cells may acquire secondary mutations that restore BRCA1/BRCA2 function, allowing homologous recombination to resume and olaparib to lose its synthetic lethality effect. |
| Other resistance mechanisms | Changes in PARP1 itself, restoration of replication fork stabilisation, upregulation of drug efflux pumps, or activation of alternative DNA repair pathways can all allow cancer cells to survive olaparib. |
| Epigenetic BRCA1 reactivation | Loss of BRCA1 promoter methylation or epigenetic changes can restore BRCA1 expression in tumours that were initially BRCA-silenced, contributing to acquired resistance. |
| Next-line treatment options | Options depend on cancer type - chemotherapy, immunotherapy, hormonal therapy, radioligand therapy in prostate cancer, other PARP inhibitors, or enrolment in clinical trials targeting resistance. |
| Molecular testing at progression | Repeat biopsy or liquid biopsy with NGS testing at progression can identify the specific resistance mechanism and guide selection of the next most appropriate treatment. |
Cost of Olaparib (Lynparza) by country
Olaparib (Lynparza) is a branded AstraZeneca/MSD targeted therapy with significant treatment costs in most markets. Patient assistance programmes and insurance coverage can substantially reduce the financial burden.
| India | Lynparza is available in India through CDSCO-approved import for certain indications. Branded costs are substantial. Manufacturer patient support may be available for eligible patients. CancerFax can guide on practical access and cost-support options. |
| USA | FDA-approved and commercially available through specialty pharmacies. Listed price is high for a monthly supply. The AstraZeneca Access 360 programme and private insurance coverage can significantly reduce out-of-pocket costs for eligible patients. |
| UK / Europe | NICE-approved in England for multiple indications with NHS funding. Cost-effectiveness varies by indication. In other European countries, national insurance reimbursement status and coverage differ by approved indication and country. |
| China | Lynparza is approved in China and has been included in national negotiations for reimbursement. Access through major cancer centres and hospital procurement. CancerFax supports China hospital coordination and access checks. |
| Patient assistance | AstraZeneca and MSD patient access and compassionate use programmes may be available in certain markets. Contact your oncologist or CancerFax for guidance on eligibility and the application process. |
Availability of Olaparib (Lynparza) globally
Olaparib is approved across major markets, though approved indications, reimbursement status, and practical access conditions vary significantly by country.
India
CDSCO has granted import and marketing permission for Lynparza for certain indications. Access through import-licensed pharmacies and hospital procurement. CancerFax can support availability checks.
USA
FDA-approved for multiple indications across ovarian, breast, prostate, and pancreatic cancers. Available at specialty pharmacies. Insurance coverage or AstraZeneca Access 360 patient support can reduce out-of-pocket costs substantially.
China
Lynparza approved for BRCA-mutated advanced ovarian cancer and BRCA-mutated mCRPC. Accessed through leading cancer hospitals. Subject to national reimbursement negotiations. CancerFax supports China hospital coordination.
UK / Europe
EMA-approved across multiple indications. NHS England funds olaparib for NICE-approved settings. Pan-European reimbursement varies by country and specific approved indication - check local guidelines.
Other countries
Olaparib availability and approved indications vary widely outside major markets. CancerFax can help verify practical access, cost, and specialist referral options wherever you are based.
Olaparib in current clinical trials
Olaparib continues to be studied in new combinations, earlier treatment lines, new cancer types, and approaches designed to overcome or delay resistance.
| Olaparib plus checkpoint immunotherapy | Multiple trials combining olaparib with PD-1/PD-L1 inhibitors in ovarian, breast, and prostate cancers - exploring whether PARP inhibition enhances immune recognition of cancer cells. |
| Olaparib plus AKT/PI3K pathway agents | Studies combining olaparib with AKT inhibitors to extend benefit to patients without HRR defects, targeting a secondary vulnerability in cancer cell survival signalling. |
| Earlier treatment settings | Trials exploring olaparib in earlier cancer stages including neoadjuvant breast cancer, early-stage ovarian cancer, and non-metastatic high-risk prostate cancer. |
| Resistance-overcoming strategies | Studies targeting patients with known olaparib resistance mechanisms - including BRCA reversion mutations - to identify whether combination approaches can restore sensitivity. |
| New cancer types with HRR defects | Investigational studies in endometrial cancer, biliary tract cancer, urothelial cancer, and other solid tumours with HRR defects where PARP inhibition may be clinically relevant. |
Your treatment journey with Olaparib
Cancer diagnosis and staging
Biomarker testing
Oncologist consultation and treatment planning
Baseline safety testing
Starting Olaparib
Blood count and safety monitoring
Scan-based response assessment
If Olaparib stops working
Questions to ask your oncologist about Olaparib
- Is olaparib approved for my cancer type and treatment line?
- Which biomarker tests do I need before starting olaparib?
- What does my BRCA or HRD result mean for my olaparib eligibility?
- Will I take olaparib alone or with another medicine?
- How long will I need to take olaparib?
- Which side effects should I report to my team urgently?
- How often do I need blood tests while on olaparib?
- Can I take my current medicines alongside olaparib?
How CancerFax supports Olaparib patients
CancerFax helps patients and families navigate the BRCA and HRD testing process, understand eligibility, and access olaparib and related advanced oncology options across India, China, and internationally.
| Medical report review | Upload your BRCA, HRD, HRR, pathology, or imaging reports - our oncology team reviews them and explains the implications for olaparib eligibility and next steps in clear, plain language. |
| Specialist connection | We connect patients with oncologists and gynaecological oncologists experienced in PARP inhibitor therapy, biomarker-selected treatment planning, and BRCA-related cancers in India and internationally. |
| Second opinion | If you are unsure about your olaparib eligibility, current treatment plan, or options after progression, CancerFax arranges specialist second opinions from oncologists with deep experience in BRCA-related cancers. |
| India and China hospital access | CancerFax coordinates access to leading cancer hospitals in India and China, including availability checks for olaparib, advanced therapy options, and clinical trial enrolment opportunities. |
| Clinical trial matching | We help patients with olaparib-resistant or advanced disease identify and access clinical trials in China, India, the USA, and internationally - including novel combination and resistance-overcoming approaches. |
| Cost and access guidance | CancerFax can guide patients on manufacturer access programmes, insurance support, and practical sourcing options for olaparib in markets where costs or availability are a challenge. |
Frequently asked questions about Olaparib
Common questions from patients and caregivers about Lynparza
Olaparib is a targeted therapy called a PARP inhibitor. Unlike chemotherapy, which attacks all rapidly dividing cells, olaparib specifically blocks PARP enzymes that cancer cells with BRCA or HRR gene defects rely on to repair their DNA. Side effects differ significantly from chemotherapy - blood count changes and fatigue are common, while hair loss is not typical of olaparib treatment.
Yes, in most situations. Olaparib is only approved for cancers with confirmed molecular features - BRCA1 or BRCA2 mutations in most indications, HRD positivity in certain ovarian cancer settings, or HRR gene alterations in prostate cancer. Your oncologist will organise germline BRCA testing from blood or saliva, and may also request somatic BRCA or HRD testing on tumour tissue. Biomarker status must be confirmed before olaparib can be appropriately prescribed.
Duration depends on the indication. As maintenance therapy - for example, in ovarian cancer after a response to platinum chemotherapy - olaparib is typically continued until disease progression or unacceptable side effects, which can be months to years. In the adjuvant breast cancer setting, treatment follows a fixed period. Your oncologist will set the expected duration based on your specific indication and response to treatment.
The two most important safety warnings for sacituzumab govitecan are severe neutropenia (dangerously low white blood cells) and severe diarrhea, both of which can be life-threatening if untreated. You should contact your oncology team immediately if you develop fever, chills, severe diarrhea, signs of infection, or difficulty breathing. Regular blood count monitoring is required throughout treatment to catch neutropenia early.
Olaparib interacts with medicines that affect CYP3A enzymes in the liver. Strong CYP3A inhibitors such as certain antifungals (itraconazole, voriconazole) significantly increase olaparib blood levels and may require dose adjustment. Strong CYP3A inducers such as rifampicin or phenytoin reduce olaparib levels and should be avoided if possible. Always bring a complete list of all medicines, supplements, and herbal products to every oncology appointment before starting olaparib.
In India, CDSCO has granted import and marketing permission for olaparib (Lynparza) tablets for certain approved indications, though indication-specific access and commercial availability can vary. In China, Lynparza holds approvals for BRCA-mutated advanced ovarian cancer and BRCA-mutated metastatic castration-resistant prostate cancer. Practical access, cost, and reimbursement status differ by country and setting - CancerFax can help verify current availability for your specific situation.
Cancer progression on olaparib usually prompts a discussion about next-line options. Your oncologist may arrange repeat biopsy or liquid biopsy, NGS testing to identify resistance mechanisms, and a review of newer targeted therapies, chemotherapy, immunotherapy, hormonal therapy, or clinical trials depending on your cancer type. CancerFax can help patients explore second opinions and advanced treatment options in India, China, and internationally when first-line options are exhausted.
No. Olaparib can harm an unborn baby. Highly effective contraception is required for women and female partners of men taking olaparib during treatment and for a defined period after the last dose. Men taking olaparib should not father children during treatment and should use condoms for several months after stopping. Always discuss pregnancy plans with your oncologist before starting olaparib, as they will advise on specific contraception timelines based on your situation.