Integrating poly(ADP-ribose) polymerase (PARP) inhibitors in the treatment of early breast cancer

Purpose of review Poly(ADP-ribose) polymerase (PARP) inhibitors were recently approved for the treatment of patients with BRCA1 or BRCA2 germline pathogenic variants and metastatic breast cancer. PARP inhibitors have also demonstrated activity in early stage breast cancer, and this review discusses completed and ongoing trials of PARP inhibitors in the neoadjuvant and adjuvant setting. Recent findings A recent phase II trial of neoadjuvant talazoparib monotherapy in patients with BRCA1 or BRCA2 germline pathogenic variants and early stage breast cancer demonstrated a pathological complete response in 10/19 (53%) patients. Previous trials of PARP inhibition in early stage breast cancer included the I-SPY-2 and BrighTNess trials, which ultimately failed to show a benefit for adding the PARP inhibitor veliparib to standard neoadjuvant chemotherapy in patients with triple-negative breast cancer. Investigators are building on these results by designing novel clinical trials for patients with BRCA1/2-deficient tumors and/or triple-negative breast cancer. Summary The OlympiAD and EMBRACA trials that led to the recent approval of PARP inhibitors for metastatic breast cancer patients with BRCA1/2 germline pathogenic variants are practice changing. Investigators are now working to translate this success into the early breast cancer setting where ongoing trials incorporate new dosing schedules, PARP inhibitor monotherapy, and novel PARP combinations.
Source: Current Opinion in Oncology - Category: Cancer & Oncology Tags: SPECIAL COMMENTARY Source Type: research

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CONCLUSION: Residual nodal disease after NAC analysed by LNRC or LNR = 0.25 cut-off value, is prognostic and can discriminate between favourable and unfavourable outcomes for TNBC and Her2+ breast cancers.
Source: Indian Journal of Cancer - Category: Cancer & Oncology Authors: Source Type: research
ConclusionWith the increasing number of elderly primigravida amongst the urban population, a clear understanding of PABC is becoming more important. A multidisciplinary team approach shall help the clinician not only in reducing the heavy burden of patient responsibility but more importantly, in guaranteeing better quality of treatment, avoiding unnecessary delays in providing interventions and providing adequate treatment.
Source: The Journal of Obstetrics and Gynecology of India - Category: OBGYN Source Type: research
This cohort study examines factors associated with lymphedema after neoadjuvant chemotherapy and axillary lymph node dissection in women with node-positive breast cancer.
Source: JAMA Surgery - Category: Sports Medicine Source Type: research
Conclusion.NAC use for BC at these South African hospitals was associated with both tumor characteristics and heterogenous resource constraints.Implications for Practice.Using data from a large breast cancer cohort treated in South Africa's public healthcare system, the authors looked at determinants of neoadjuvant chemotherapy use and time to initiate treatment. It was found that neoadjuvant chemotherapy was associated with increasing tumor burden and aggressive molecular subtypes, demonstrating clinically appropriate care in a lower resource setting. Results of this study also showed that time to treatment differences be...
Source: The Oncologist - Category: Cancer & Oncology Authors: Tags: Breast Cancer, Health Outcomes and Economics of Cancer Care, Global Health and Cancer Source Type: research
Conditions:   Breast Cancer;   Invasive Ductal Breast Carcinoma;   Invasive Lobular Breast Carcinoma Intervention:   Diagnostic Test: Radiomic, pathomic, and clinical markers Sponsor:   Sunnybrook Health Sciences Centre Active, not recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
Authors: Ahmed SH Abstract Introduction: Preoperative systemic therapy (PST) including neoadjuvant chemotherapy (NAC) in breast cancer (BC) is used nowadays on a large scale especially in aggressive BC subtypes. The use of NAC in BC may be associated with some safety issues and hazards including possible increased rate of locoregional recurrence, inadequate staging with subsequent over or under-treatment, and surgical complications. Areas covered: This review article aims to discuss these concerns and to clarify the adequate steps and procedures needed to increase safety and alleviate the possible drawbacks of NAC....
Source: Expert Opinion on Drug Safety - Category: Drugs & Pharmacology Tags: Expert Opin Drug Saf Source Type: research
This article gives a summary of several studies presented at the San Antonio Breast Cancer Symposium in 2018. In specific, the biomarker analysis of the ‘IMpassion130’ trial, the effects of CDK4/6 inhibitors on T-cells and tumor immunogenicity, adjuvant chemotherapy in older patients, the prognostic relevance of achieving a pathologic complete response after neoadjuvant therapy, the quality of life analysis of the ‘TAILORx’ trial, the progno stic impact of detecting bone marrow tumor cells at the time of primary resection and b-cell lymphoma 2 as a new possible therapeutic target in luminal breast c...
Source: Memo - Magazine of European Medical Oncology - Category: Cancer & Oncology Source Type: research
Condition:   Breast Cancer Interventions:   Procedure: Omission of Axillary dissection;   Procedure: Axillary dissection Sponsor:   Istituto Clinico Humanitas Recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
Authors: Morigi C Abstract The 16th St Gallen International Breast Cancer Conference took place in Vienna for the third time, from 20-23 March 2019. More than 3000 people from all over the world were invited to take part in this important bi-annual critical review of the 'state of the art' in the primary care of breast cancer (BC), independent of political and industrial pressure, with the aim to integrate the most recent research data and most important developments in BC therapies since St Gallen International Breast Cancer Conference 2017, with the ultimate goal of drawing up a consensus for the current optimal ...
Source: Ecancermedicalscience - Category: Cancer & Oncology Tags: Ecancermedicalscience Source Type: research
Authors: Jang Y, Cho EY, Cho SY Abstract Mucinous carcinoma (MC) is a rare subtype of breast cancer, which is composed of tumor cells floating in the abundant extracellular mucin. This form of cancer is usually estrogen receptor/progesterone receptor positive and human epidermal growth factor receptor 2 (HER2) negative. Here, we present a case of HER2-positive MC with an unusual signet ring cell differentiation. It is very rare that a breast tumor consists entirely of signet ring cells. The tumor showed pathologic complete response (pCR) after neoadjuvant chemotherapy with trastuzumab and pertuzumab. pCR of HER2-po...
Source: Journal of Breast Cancer - Category: Cancer & Oncology Tags: J Breast Cancer Source Type: research
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