There are lots of different PARP inhibitors currently on the market for breast cancer – there’s olaparib approved and talazoparib approved. They were tested as monotherapy in a somewhat heavily pre-treated population. So they show very high response rates, a somewhat disappointing progression free survival but the advantage with giving olaparib and talazoparib is that they are oral agents. So patients can go on holidays and have really good quality of life. The question for us now is how to improve on that, whether it’s giving an immunotherapy or whether it’s giving another DDR damaging agent, and what to do with patients after they progress on a PARP inhibitor. Is that because they have reverted their BRCAness or they’ve developed other mechanisms of resistance?
The question for me is what’s the best strategy for these patients for quality of life. Is it a PARP inhibitor up front or is it a chemo combination followed by PARP inhibitor? I think that’s the main thing in the field at the moment.
