Olaparib for metastatic breast cancer in patients with a germline BRCA mutation Journal Article


Authors: Robson, M.; Im, S. A.; Senkus, E.; Xu, B.; Domchek, S. M.; Masuda, N.; Delaloge, S.; Li, W.; Tung, N.; Armstrong, A.; Wu, W.; Goessl, C.; Runswick, S.; Conte, P.
Article Title: Olaparib for metastatic breast cancer in patients with a germline BRCA mutation
Abstract: BACKGROUND Olaparib is an oral poly(adenosine diphosphate-ribose) polymerase inhibitor that has promising antitumor activity in patients with metastatic breast cancer and a germline BRCA mutation. METHODS We conducted a randomized, open-label, phase 3 trial in which olaparib monotherapy was compared with standard therapy in patients with a germline BRCA mutation and human epidermal growth factor receptor type 2 (HER2)-negative metastatic breast cancer who had received no more than two previous chemotherapy regimens for metastatic disease. Patients were randomly assigned, in a 2: 1 ratio, to receive olaparib tablets (300 mg twice daily) or standard therapy with single-agent chemotherapy of the physician's choice (capecitabine, eribulin, or vinorelbine in 21-day cycles). The primary end point was progression-free survival, which was assessed by blinded independent central review and was analyzed on an intention-to-treat basis. RESULTS Of the 302 patients who underwent randomization, 205 were assigned to receive olaparib and 97 were assigned to receive standard therapy. Median progression-free survival was significantly longer in the olaparib group than in the standardtherapy group (7.0 months vs. 4.2 months; hazard ratio for disease progression or death, 0.58; 95% confidence interval, 0.43 to 0.80; P<0.001). The response rate was 59.9% in the olaparib group and 28.8% in the standard-therapy group. The rate of grade 3 or higher adverse events was 36.6% in the olaparib group and 50.5% in the standard-therapy group, and the rate of treatment discontinuation due to toxic effects was 4.9% and 7.7%, respectively. CONCLUSIONS Among patients with HER2-negative metastatic breast cancer and a germline BRCA mutation, olaparib monotherapy provided a significant benefit over standard therapy; median progression-free survival was 2.8 months longer and the risk of disease progression or death was 42% lower with olaparib monotherapy than with standard therapy. (Funded by AstraZeneca; OlympiAD ClinicalTrials.gov number, NCT02000622.)
Keywords: trial; phase-2; carriers; scores; international consensus guidelines; abc 3
Journal Title: New England Journal of Medicine
Volume: 377
Issue: 6
ISSN: 0028-4793
Publisher: Massachusetts Medical Society  
Date Published: 2017-08-10
Start Page: 523
End Page: 533
Language: English
ACCESSION: WOS:000407212600005
DOI: 10.1056/NEJMoa1706450
PROVIDER: wos
PUBMED: 28578601
Notes: Article -- Source: Wos
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  1. Mark E Robson
    488 Robson