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Adjuvant Olaparib for Germline BRCA Carriers With HER2-Negative Early Breast Cancer: Evidence and Controversies

Year: 2023
Type: review
Abstract: 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.
DOI: 10.1093/oncolo/oyad123
Authors: Stefania Morganti, Brittany L Bychkovsky, Philip D Poorvu, Ana C Garrido-Castro, Anna Weiss, Caroline C Block, Ann H Partridge, Giuseppe Curigliano, Nadine M Tung, Nancy U Lin, Judy E Garber, Sara M Tolaney, Filipa Lynce
Institutions: Broad Institute, Harvard University, University of Milan, Dana-Farber Cancer Institute, Dana-Farber Brigham Cancer Center, European Institute of Oncology, University of Rochester Medicine, University of Rochester, Beth Israel Deaconess Medical Center
Language: English
Subfield: Oncology
Field: Medicine
Open Access status: gold
Estimated APC paid: $3,494
OpenAlex ID: W4377157973
FWCI: 0.647
Cites: 71
Cited by: 20
Related to: 10