# OlympiAD

Source: https://onco.cc/trials/olympiad/  
OnCo record `olympiad` (Trial). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

OlympiAD was the first trial to show a PARP inhibitor tablet beats chemotherapy in breast cancer, delaying progression by about three months in women with an inherited BRCA mutation and with fewer side effects, though it did not lengthen life overall.

## Summary

OlympiAD, trial NCT02000622 sponsored by AstraZeneca and published in the New England Journal of Medicine in 2017, randomised 302 patients with a germline BRCA1 or BRCA2 mutation and HER2-negative metastatic breast cancer, about half triple-negative, to olaparib tablets or the physician's choice of capecitabine, eribulin or vinorelbine. Progression-free survival rose from 4.2 to 7.0 months (hazard ratio 0.58), the response rate doubled and severe side effects were less common with olaparib; overall survival was 19.3 against 17.1 months and not significantly different, with a suggestion of benefit in patients who had not had chemotherapy for metastatic disease. It led to the January 2018 approval of olaparib, the first PARP inhibitor for breast cancer, and made germline testing a treatment decision in metastatic disease. Whether PARP inhibition should come before or after platinum, to which it shares a mechanism of resistance, is the open question.

## Fields

- Kind: Trial
- Status: positive
- Last checked: 2026-09-17
- Registry id: NCT02000622
- Phase: 3
- Setting: Germline BRCA-mutated, HER2-negative metastatic breast cancer after up to two chemotherapy lines: olaparib vs physician's choice chemotherapy
- Sponsor: AstraZeneca
- Enrolled: 302
- Result: PFS 7.0 vs 4.2 months, HR 0.58; OS 19.3 vs 17.1 months, not significant.
- Outcomes: Progression-free survival: Olaparib 7 months vs Chemotherapy 4.2 months, HR 0.58; Overall survival: Olaparib 19.3 months vs Chemotherapy 17.1 months, HR 0.9
- Replication: EMBRACA with talazoparib reached the same conclusion; neither trial showed an overall survival benefit.

## Notes

- Triple-negative subgroup, final overall survival (Annals of Oncology 2019): hazard ratio 0.93 (0.62 to 1.43) against 0.86 in hormone-receptor-positive disease; patients with no prior chemotherapy for metastatic disease 0.51 (0.29 to 0.90). Six UK sites (Aberdeen, Colchester, Coventry, London, Manchester, Plymouth). England: NICE TA1040 (12 February 2025) commissions olaparib for this indication.

## Sources

- ClinicalTrials.gov NCT02000622: https://clinicaltrials.gov/study/NCT02000622
- Robson et al., OlympiAD (NEJM 2017): https://doi.org/10.1056/NEJMoa1706450
- OlympiAD final overall survival (Annals of Oncology 2019): https://doi.org/10.1093/annonc/mdz012
- NICE TA1040 (12 February 2025): https://www.nice.org.uk/guidance/ta1040

## Connected records

- cancers: [BRCA-associated triple-negative breast cancer](https://onco.cc/cancers/brca-associated-tnbc/), [HR-positive / HER2-negative breast cancer](https://onco.cc/cancers/breast-hr-positive/), [HR-positive metastatic breast cancer after CDK4/6 inhibitors](https://onco.cc/cancers/hr-positive-metastatic-post-cdk46/), [Metastatic triple-negative breast cancer](https://onco.cc/cancers/tnbc-metastatic/), [Triple-negative breast cancer (TNBC)](https://onco.cc/cancers/tnbc/)
- technologies: [PARP inhibitors](https://onco.cc/technologies/parp-inhibitor/)
- targets: [BRCA1 / BRCA2 (HRD)](https://onco.cc/targets/brca/), [PARP](https://onco.cc/targets/parp/)
- drugs: [Capecitabine](https://onco.cc/drugs/capecitabine/), [Eribulin](https://onco.cc/drugs/eribulin/), [Olaparib](https://onco.cc/drugs/olaparib/), [Vinorelbine](https://onco.cc/drugs/vinorelbine/)
- companies: [AstraZeneca](https://onco.cc/companies/astrazeneca/)
- terms: [Germline BRCA mutation (gBRCA)](https://onco.cc/terms/gbrca-mutation/)
- key papers: [ESMO Clinical Practice Guideline for the diagnosis, staging and treatment of patients with metastatic breast cancer](https://onco.cc/key-papers/paper-esmo-metastatic-breast-cancer-guideline-ann-oncol-2021/), [Management of Hereditary Breast Cancer: American Society of Clinical Oncology, American Society for Radiation Oncology, and Society of Surgical Oncology Guideline](https://onco.cc/key-papers/paper-asco-hereditary-breast-cancer-guideline-jco-2020/), [OlympiAD final overall survival and tolerability results: Olaparib versus chemotherapy treatment of physician's choice in patients with a germline BRCA mutation and HER2-negative metastatic breast cancer](https://onco.cc/key-papers/paper-olympiad-ann-oncol-2019-update/), [OlympiAD: olaparib versus chemotherapy in metastatic breast cancer with a germline BRCA mutation](https://onco.cc/key-papers/paper-olympiad-nejm-2017/)
- roadmaps: [Triple-negative breast cancer roadmap: from a remainder defined by three negative tests to immunotherapy, antibody-drug conjugates and the residual disease problem](https://onco.cc/roadmaps/tnbc-roadmap/)
- trials: [BROCADE3](https://onco.cc/trials/brocade3/), [TNT (Triple Negative Trial)](https://onco.cc/trials/tnt/)

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