Efficacy and safety of Olaparib in cancer treatment: A systematic review

Abstract

Introduction: Olaparib has become a key treatment for a wide range of solid tumors characterized by defects in homologous recombination repair. Its integration into clinical practice has transformed the management of several malignancies; however, its optimal use requires careful patient selection and appropriate toxicity management, both of which are essential components of oncology pharmacy practice. Materials and methods: A systematic review of phase II and III clinical trials published between 2020 and 2025 was conducted using PubMed, Web of Science, and Scopus, in accordance with PRISMA guidelines. Studies evaluating the efficacy and safety of olaparib in advanced breast, ovarian, pancreatic, and prostate cancers were included. Results: Seventeen studies were selected for review. Robust evidence from phase III trials supports the use of olaparib in ovarian, pancreatic, and prostate cancers with BRCA mutations. In contrast, evidence in triple?negative breast cancer remains limited and heterogeneous. Combination strategies may improve progression?free survival, although they are associated with increased toxicity. Conclusions: Olaparib provides a clear clinical benefit in biomarker?selected populations, particularly in patients with BRCA mutations. From an oncology pharmacy perspective, its use requires the integration of molecular diagnostics, toxicity monitoring, and management of drug–drug interactions. Evidence supporting broader use beyond BRCA?mutated populations remains inconsistent and should be interpreted with caution.