Recently published results from the randomised phase III adjuvant therapy OlympiA
trial are a significant development for patients with hereditary breast cancer in
the era of precision medicine. OlympiA has shown adjuvant treatment with a poly (ADP-ribose)
polymerase (PARP) inhibitor significantly improves outcomes in patients with germline
BRCA-mutated early breast cancer.
1
,2
PARP inhibitors are already approved for use in Australia in patients with germline
BRCA1/2 mutations that have either high stage, high grade ovarian carcinomas or metastatic
HER2-negative breast cancer. The American Society of Clinical Onocology (ASCO), National
Cancer Comprehensive Network (NCCN) and St Gallen Early Breast Cancer Consensus updated
guidelines now also include treatment with olaparib to improve outcomes for patients
with an inherited mutation in BRCA1 or BRCA2 with early stage, HER2-negative breast cancer who have a high recurrence risk based
on the results of OlympiA.
1
,3
,
- Tung N.M.
- Zakalik D.
- Somerfield M.R.
Hereditary breast cancer guideline expert panel. Adjuvant PARP inhibitors in patients
with high-risk early-stage HER2-negative breast cancer and germline BRCA mutations:
ASCO hereditary breast cancer guideline rapid recommendation update.
J Clin Oncol. 2021; 39: 2959-2961
4
,
National Comprehensive Cancer Network. Breast cancer. Cited 11 Feb 2022. https://www.nccn.org/professionals/physician_gls/pdf/breast.pdf.
5
The United States Food and Drug Administration (FDA) approved the PARP inhibitor
olaparib in high recurrence risk early breast cancer patients with germline BRCA1/2 mutations in March 2022.
6
A large number of ongoing clinical trials are examining olaparib and other PARP inhibitors
in early breast cancer. These recent advances are bringing PARP inhibitors into the
clinic for early breast cancer patients. As more targeted therapies become available
and new prognostic and predictive biomarkers emerge, the role that pathologists play
in clinical trials and in changing clinical practice is becoming increasingly important.US Food and Drug Administration. FDA approves olaparib for adjuvant treatment of high-risk early breast cancer. Updated 11 Mar 2022. https://www.fda.gov/drugs/resources-information-approved-drugs/fda-approves-olaparib-adjuvant-treatment-high-risk-early-breast-cancer.
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References
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- Pre-specified event driven analysis of overall survival (OS) in the OlympiA phase III trial of adjuvant olaparib (OL) in germline BRCA1/2 mutation (gBRCAm) associated breast cancer. ESMO virtual plenary sessions.16 Mar 2022
- Hereditary breast cancer guideline expert panel. Adjuvant PARP inhibitors in patients with high-risk early-stage HER2-negative breast cancer and germline BRCA mutations: ASCO hereditary breast cancer guideline rapid recommendation update.J Clin Oncol. 2021; 39: 2959-2961
National Comprehensive Cancer Network. Breast cancer. Cited 11 Feb 2022. https://www.nccn.org/professionals/physician_gls/pdf/breast.pdf.
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US Food and Drug Administration. FDA approves olaparib for adjuvant treatment of high-risk early breast cancer. Updated 11 Mar 2022. https://www.fda.gov/drugs/resources-information-approved-drugs/fda-approves-olaparib-adjuvant-treatment-high-risk-early-breast-cancer.
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Article info
Publication history
Published online: June 29, 2022
Accepted:
May 31,
2022
Received in revised form:
May 27,
2022
Received:
March 29,
2022
Identification
Copyright
© 2022 Royal College of Pathologists of Australasia. Published by Elsevier B.V. All rights reserved.
