NICE approves olaparib for early-stage breast cancer and prostate cancer

The UK’s National Institute for Health and Clinical Excellence (NICE) has recommended that Lynparza (olaparib) can be used for NHS patients with both early-stage breast cancer and prostate cancer. Olaparib is PARP inhibitor that targets cancers linked to faulty BRCA1 or BRCA2 genes and works across many different cancer types. The recommendation will grant patients in England and Wales with early-stage, high-risk breast cancer and inherited mutations in BRCA1 or BRCA2 access to olaparib following standard treatment. Men in England and Wales with advanced, incurable prostate cancer who have BRCA1/2 mutations in their tumours and who have seen their cancer progress despite hormone therapy will also have access to olaparib. The decision is the result of complex negotiations between NHS England and manufacturer AstraZeneca over how to price the drug for different groups of cancer patients. NICE previously decided not to recommend the drug as a prostate cancer treatment due to the high cost of genetic testing. Olaparib has been available on the NHS in England and Wales for women with advanced ovarian cancer, and inherited BRCA1 or BRCA2 mutations, who have stopped responding to treatment since January 2020. In Scotland, it has been available for these patients since July 2021 and has also been available for men with advanced, hormone-relapsed prostate cancer whose tumours have mutations in BRCA1 or BRCA2, since October 2021. Olaparib is also licensed for use in patients with BRCA1 and BRCA2 mutations and advanced breast and pancreatic cancer, but it is not yet available on the NHS. A long scientific journey The decision has been welcomed by the Institute of Cancer Research (ICR). Scientists from the ICR were the first to demonstrate that cancer cells with mutations in BRCA1 or BRCA2 were highly susceptible to PARP inhibitors. Professor Andrew Tutt, Professor of Breast Oncology at The Institute of Cancer Research, London, and King’s College London, was the lead Principal Investigator of the Phase III OlympiA trial in high risk early-stage breast cancer. Professor Tutt commented: “This is an amazing moment in a long scientific journey – starting with the discovery of the BRCA1 and BRCA2 genes more than 25 years ago, to ICR scientists identifying how to target a weakness in these cancers 10 years later, all the way through to the completion of the Phase III clinical trials which led to today’s recommendations. It is immensely satisfying to know this work will now allow patients within the NHS to join the many thousands of patients globally whose lives are transformed by this work.”