학술논문
Adjuvant Olaparib for Germline BRCA Carriers With HER2-Negative Early Breast Cancer: Evidence and Controversies
Document Type
Report
Author
Source
The Oncologist. July 2023, Vol. 28 Issue 7, p565, 10 p.
Subject
Language
English
ISSN
1083-7159
Abstract
Implications for Practice In the OlympiA trial, 1 year of adjuvant olaparib improved the survival of germline BRCA mutation (gBRCAm) carriers with high-risk, HER2-negative early-stage breast cancer. However, novel agents [...]
In the OlympiA study, 1 year of adjuvant olaparib significantly extended invasive disease-free survival and overall survival. The benefit was consistent across subgroups, and this regimen is now recommended after chemotherapy for germline BRCA1/2 mutation (gBRCA1/2m) carriers with high-risk, HER2-negative early breast cancer. However, the integration of olaparib in the landscape of agents currently available in the post(neo) adjuvant setting--ie, pembrolizumab, abemaciclib, and capecitabine--is challenging, as there are no data suggesting how to select, sequence, and/or combine these therapeutic approaches. Furthermore, it is unclear how to best identify additional patients who could benefit from adjuvant olaparib beyond the original OlympiA criteria. Since it is unlikely that new clinical trials will answer these questions, recommendations for clinical practice can be made through indirect evidence. In this article, we review available data that could help guide treatment decisions for gBRCA1/2m carriers with high-risk, early-stage breast cancer. Key words: germline BRCA; early breast cancer; olaparib; adjuvant; OlympiA.
In the OlympiA study, 1 year of adjuvant olaparib significantly extended invasive disease-free survival and overall survival. The benefit was consistent across subgroups, and this regimen is now recommended after chemotherapy for germline BRCA1/2 mutation (gBRCA1/2m) carriers with high-risk, HER2-negative early breast cancer. However, the integration of olaparib in the landscape of agents currently available in the post(neo) adjuvant setting--ie, pembrolizumab, abemaciclib, and capecitabine--is challenging, as there are no data suggesting how to select, sequence, and/or combine these therapeutic approaches. Furthermore, it is unclear how to best identify additional patients who could benefit from adjuvant olaparib beyond the original OlympiA criteria. Since it is unlikely that new clinical trials will answer these questions, recommendations for clinical practice can be made through indirect evidence. In this article, we review available data that could help guide treatment decisions for gBRCA1/2m carriers with high-risk, early-stage breast cancer. Key words: germline BRCA; early breast cancer; olaparib; adjuvant; OlympiA.