For certain patients with metastatic castration-resistant prostate cancer

	View complete Prescribing Information and Important Safety Information

	Dear Healthcare Professional,

Please see below information about the role of LYNPARZA for your eligible patients with mCRPC. LYNPARZA provides a treatment option when HRR gene–mutated mCRPC progresses following prior treatment with enzalutamide or abiraterone.1,2

	INDICATION
	LYNPARZA is a poly (ADP-ribose) polymerase (PARP) inhibitor indicated for the treatment of adult patients with deleterious or suspected deleterious germline or somatic homologous recombination repair (HRR) gene-mutated metastatic castration-resistant prostate cancer (mCRPC) who have progressed following prior treatment with enzalutamide or abiraterone. Select patients for therapy based on an FDA-approved companion diagnostic for LYNPARZA.
	IMPORTANT SAFETY INFORMATION
	CONTRAINDICATIONS
	There are no contraindications for LYNPARZA.
	WARNINGS AND PRECAUTIONS
	Myelodysplastic Syndrome/Acute Myeloid Leukemia (MDS/AML): Occurred in approximately 1.5% of patients exposed to LYNPARZA monotherapy, and the majority of events had a fatal outcome. The median duration of therapy in patients who developed MDS/AML was 2 years (range: <6 months to >10 years). All of these patients had previous chemotherapy with platinum agents and/or other DNA-damaging agents, including radiotherapy.
	Do not start LYNPARZA until patients have recovered from hematological toxicity caused by previous chemotherapy (≤Grade 1). Monitor complete blood count for cytopenia at baseline and monthly thereafter for clinically significant changes during treatment. For prolonged hematological toxicities, interrupt LYNPARZA and monitor blood count weekly until recovery.
	If the levels have not recovered to Grade 1 or less after 4 weeks, refer the patient to a hematologist for further investigations, including bone marrow analysis and blood sample for cytogenetics. Discontinue LYNPARZA if MDS/AML is confirmed.
	Please see additional Important Safety Information, including continued Warnings and Precautions for Pneumonitis, Embryo-Fetal Toxicity, and VTE, below.

mCRPC treatment pathway with olaparib in patients with an HRR gene mutation3 Other treatment pathways may occur depending on patient circumstances. Refer to the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for additional treatment considerations. NCCN makes no warranties of any kind whatsoever regarding their content, use or application and disclaims any responsibility for their application or use in any way. In PROfound, LYNPARZA was used in the mCRPC setting, regardless of prior taxane use.1

	PROfound WAS A PHASE 3 TRIAL OF A PARPi IN mCRPC THAT EVALUATED MULTIPLE CLINICAL ENDPOINTS1

	IMPORTANT SAFETY INFORMATION (Cont’d)
	WARNINGS AND PRECAUTIONS (Cont’d)
	Pneumonitis: Occurred in 0.8% of patients exposed to LYNPARZA monotherapy, and some cases were fatal. If patients present with new or worsening respiratory symptoms such as dyspnea, cough, and fever, or a radiological abnormality occurs, interrupt LYNPARZA treatment and initiate prompt investigation. Discontinue LYNPARZA if pneumonitis is confirmed and treat patient appropriately.
	Embryo-Fetal Toxicity: Based on its mechanism of action and findings in animals, LYNPARZA can cause fetal harm. A pregnancy test is recommended for females of reproductive potential prior to initiating treatment.
	Females
	Advise females of reproductive potential of the potential risk to a fetus and to use effective contraception during treatment and for 6 months following the last dose.
	Males
	Advise male patients with female partners of reproductive potential or who are pregnant to use effective contraception during treatment and for 3 months following the last dose of LYNPARZA and to not donate sperm during this time.
	Venous Thromboembolic Events: Including pulmonary embolism, occurred in 7% of patients with metastatic castration-resistant prostate cancer who received LYNPARZA plus androgen deprivation therapy (ADT) compared to 3.1% of patients receiving enzalutamide or abiraterone plus ADT in the PROfound study. Patients receiving LYNPARZA and ADT had a 6% incidence of pulmonary embolism compared to 0.8% of patients treated with ADT plus either enzalutamide or abiraterone. Monitor patients for signs and symptoms of venous thrombosis and pulmonary embolism, and treat as medically appropriate, which may include long-term anticoagulation as clinically indicated.
	ADVERSE REACTIONS—HRR Gene-mutated Metastatic Castration-Resistant Prostate Cancer
	Most common adverse reactions (Grades 1‑4) in ≥10% of patients in clinical trials of LYNPARZA for PROfound were: anemia (46%), fatigue (including asthenia) (41%), nausea (41%), decreased appetite (30%), diarrhea (21%), vomiting (18%), thrombocytopenia (12%), cough (11%), and dyspnea (10%).
	Most common laboratory abnormalities (Grades 1‑4) in ≥25% of patients in clinical trials of LYNPARZA for PROfound were: decrease in hemoglobin (98%), decrease in lymphocytes (62%), decrease in leukocytes (53%), and decrease in absolute neutrophil count (34%).
	DRUG INTERACTIONS
	Anticancer Agents: Clinical studies of LYNPARZA with other myelosuppressive anticancer agents, including DNA-damaging agents, indicate a potentiation and prolongation of myelosuppressive toxicity.
	CYP3A Inhibitors: Avoid coadministration of strong or moderate CYP3A inhibitors when using LYNPARZA. If a strong or moderate CYP3A inhibitor must be coadministered, reduce the dose of LYNPARZA. Advise patients to avoid grapefruit, grapefruit juice, Seville oranges, and Seville orange juice during LYNPARZA treatment.
	CYP3A Inducers: Avoid coadministration of strong or moderate CYP3A inducers when using LYNPARZA.
	USE IN SPECIFIC POPULATIONS
	Lactation: No data are available regarding the presence of olaparib in human milk, its effects on the breastfed infant or on milk production. Because of the potential for serious adverse reactions in the breastfed infant, advise a lactating woman not to breastfeed during treatment with LYNPARZA and for 1 month after receiving the final dose.
	Pediatric Use: The safety and efficacy of LYNPARZA have not been established in pediatric patients.
	Hepatic Impairment: No adjustment to the starting dose is required in patients with mild or moderate hepatic impairment (Child-Pugh classification A and B). There are no data in patients with severe hepatic impairment (Child-Pugh classification C).
	Renal Impairment: No dosage modification is recommended in patients with mild renal impairment (CLcr 51-80 mL/min estimated by Cockcroft-Gault). In patients with moderate renal impairment (CLcr 31-50 mL/min), reduce the dose of LYNPARZA to 200 mg twice daily. There are no data in patients with severe renal impairment or end-stage renal disease (CLcr ≤30 mL/min).
	Please see complete Prescribing Information, including Patient Information (Medication Guide).
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	HRR=homologous recombination repair; HRRm=homologous recombination repair gene–mutated; mCRPC=metastatic castration-resistant prostate cancer; NCCN=National Comprehensive Cancer Network; PARPi=poly (ADP-ribose) polymerase inhibitor.
	References: 1. LYNPARZA® (olaparib) [prescribing information]. Wilmington, DE: AstraZeneca Pharmaceuticals LP; 2021. 2. Teo MY, Rathkopf DE, Kantoff P. Treatment of advanced prostate cancer. Annu Rev Med. 2019;70:479-499. 3. Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Prostate Cancer V.2.2021. © National Comprehensive Cancer Network, Inc. 2021. All rights reserved. Accessed April 17, 2021. To view the most recent and complete version of the guideline, go online to NCCN­.­org.
	This product information is intended for US health care professionals only.
	LYNPARZA is a registered trademark of the AstraZeneca group of companies.
	©2021 AstraZeneca. All rights reserved. US-58262 Last Updated 10/­21