PARP inhibitors for metastatic breast cancer

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Published: 7 Oct 2019
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Prof Michael Untch - Helios Hospital Berlin-Buch, Berlin, Germany

Prof Michael Untch speaks to ecancer at ESMO 2019 in Barcelona about some of the trials covering PARP inhibitors for metastatic breast cancer.

Prof Untch outlines the OlympiAD and EMBRACA trials for patients with BRCA mutations, both with positive results.

He also touches on the BrighTNess study which involves a new PARP inhibitor, veliparib.

This programme has been supported by an unrestricted educational grant from Pfizer.

 

Number one, we have done several studies with the addition of PARP inhibitors in patients who have metastatic breast cancer; two of the biggest ones, the OlympiAD study with olaparib and the EMBRACA study with talazoparib. Now, these studies have been done in patients who have a BRCA mutation. The incident is about between 5-10% in all metastatic breast cancer patients, irrespective of whether they have a triple negative breast cancer, in which the incidence is somewhat higher, or a hormone receptor positive, HER2 negative breast cancer, the incidence in these patients is between 5-8%.

The bottom line of the results of both studies is very positive that, compared to standard chemotherapy, these patients were doing much better so the progression free survival was significantly higher. Therefore I look forward to the overall survival data of both studies. Both drugs actually have been approved in the US by the FDA and in Europe by the authorities for the treatment of metastatic breast cancer patients who have BRCA mutations.

Now, I’m under still the very positive result of the ovarian cancer patients which we have seen yesterday because we also treat a lot of ovarian cancer patients. This is a revolution in the treatment of ovarian cancer patients also so we see very, very close similarities between the therapeutic principle of PARP inhibition. So I would call the PARP inhibition one of the major revolutions in the last ten years in both the treatment of ovarian cancer patients and breast cancer patients. So I look forward to even more studies we are doing like neoadjuvant trials with PARP inhibitors, post-neoadjuvant trials. So this is a very exciting era in oncology today.

We have seen yesterday very nice results with a third PARP inhibitor which is veliparib. Also that was shown in ovarian cancer with very positive results. We have done one neoadjuvant trial with that drug, with veliparib, in patients who have a BRCA mutation, the study is called BrighTNess. The first results have been published in Lancet Oncology last year but we still wait for outcome results. That was just published in terms of pathologic complete response rate after neoadjuvant treatment with anthracycline, taxanes, platinum and a PARP inhibitor but we have to wait for results in the outcome of these patients from the BrighTNess study.