Olaparib does not cause clinically relevant QT/QTc interval prolongation in patients with advanced solid tumours: results from two phase I studies

Cancer Chemother Pharmacol. 2016 Oct;78(4):775-84. doi: 10.1007/s00280-016-3124-5. Epub 2016 Aug 23.

Abstract

Background: Some therapeutic agents in oncology can be causally associated with specific cardiovascular events including QT/QTc interval prolongation. We investigated the effect of multiple dosing of the oral poly (ADP-ribose)-polymerase (PARP) inhibitor, olaparib (tablet formulation) on QT/QTc interval.

Methods: Two phase I, open-label, three-part studies (NCT01921140 [study 4] and NCT01900028 [study 7]) were conducted in adults with refractory/resistant advanced solid tumours. In both studies, parts A and B assessed the QT/QTc interval effects of single-dose oral olaparib 100 (study 4) or 300 (study 7) mg and multiple-dose olaparib 300 mg bid for 5 days, respectively, while part C evaluated continued access to olaparib for additional safety analyses. An ANCOVA model tested the primary objective of multiple-dose effects of olaparib on QT interval corrected using Fridericia's formula (QTcF).

Results: Data from 119 and 109 patients were pooled from parts A and B, respectively, for QT/QTc analysis. At pre-dose and up to 12 h post-dose, the upper limits of the 90 % confidence intervals (CIs) for the difference in QTcF least squares means after olaparib multiple dosing versus control (day -1) were <10 ms, suggesting a lack of clinically relevant effect on cardiac repolarization. A slight shortening of QTcF was observed at most time points versus control. QTcF results for the individual studies and single-dose olaparib paralleled the primary multiple-dose pooled analysis, with upper limits of the 90 % CIs < 10 ms.

Conclusion: Olaparib tablets administered as multiple or single doses had no clinically significant effect on QT/QTc interval.

Keywords: Cardiac repolarization; Heart rate; Olaparib; Phase I; QT interval; QTc interval; Safety.

Publication types

  • Clinical Trial, Phase I
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cross-Over Studies
  • Dose-Response Relationship, Drug
  • Drug Resistance, Neoplasm
  • Electrocardiography / drug effects
  • Female
  • Heart Rate / drug effects
  • Humans
  • Long QT Syndrome / chemically induced*
  • Long QT Syndrome / epidemiology
  • Male
  • Middle Aged
  • Neoplasms / complications*
  • Neoplasms / drug therapy
  • Phthalazines / administration & dosage
  • Phthalazines / adverse effects*
  • Phthalazines / therapeutic use
  • Piperazines / administration & dosage
  • Piperazines / adverse effects*
  • Piperazines / therapeutic use
  • Poly(ADP-ribose) Polymerase Inhibitors / administration & dosage
  • Poly(ADP-ribose) Polymerase Inhibitors / adverse effects*
  • Poly(ADP-ribose) Polymerase Inhibitors / therapeutic use

Substances

  • Phthalazines
  • Piperazines
  • Poly(ADP-ribose) Polymerase Inhibitors
  • olaparib