PARP inhibitors have recently been approved and made available in the United States for metastatic breast cancer that’s associated with a BRCA1 or BRCA2 deleterious mutation. We have two such agents available for patients based on the demonstration of a three month improvement in median progression free survival. Overall survival has not yet been demonstrated, the data, I believe, are still maturing. These drugs are generally well tolerated, they are oral agents, their main side effects are cytopenias. I think it’s very exciting because for many of these patients, especially with BRCA1 mutations where they have triple negative disease often, this gives patients a non-chemotherapy option that will expand their time that they can live with their disease controlled. I’m very excited to see PARP inhibitors combined with other therapies to see if that will further improve outcomes for these women.

Is there an expansion to treat patients with other deleterious germline mutations except for BRCA1 and BRCA2?

At this moment PARP inhibitors are really best supported to be used in patients who carry a BRCA1 or 2 mutation. They have not been well analysed in patients that have other mutations associated with homologous recombination. There are ongoing trials so for my own patients who are found to have a mutation in one of these other genes I’m referring them for clinical trials to look at whether or not PARP inhibitor or other therapies that are combined with a PARP inhibitor might improve their outcomes.