Drug Lynparza Helps Fight Some Early-Stage Breast Cancers

By Dennis Thompson
Health Day reporter

FRIDAY, June 4, 2021 (HealthDay News) – One pill twice a day can significantly reduce the risk of breast cancer recurrence in women genetically predisposed to the disease, researchers report.

The pill – olaparib (Lynparza) – works by blocking a natural enzyme called PARP that normally corrects DNA damage in healthy cells, but in these women it actually promotes the growth of cancer cells.

Early-stage, high-risk breast cancer patients taking olaparib for one year had a 42% reduced risk of cancer recurrence or death compared to those receiving placebo, said lead researcher, the Dr Andrew Tutt, director of the Breast Cancer Now Toby Robins Research Center at the Cancer Research Institute in London.

“Patients who received olaparib after surgery and chemotherapy were more likely to be alive without cancer and avoid metastasis than patients who received placebo,” he said.

These results were presented Thursday at an online meeting of the American Society of Clinical Oncology. The results presented at the meetings should be considered preliminary until they are published in a peer-reviewed journal.

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Olaparib is already approved to treat patients with metastatic breast cancer who have mutations in the BRCA1 or BRCA2 genes. These genes usually suppress cancer, but the mutations actually increase the risk of cancer in some people.

About 5% of breast cancers are associated with BRCA1 or BRCA2 mutations, Tutt noted.

Breast cancers that occur due to BRCA1 or BRCA2 mutations rely on the PARP enzyme to stay alive, grow and divide. Drugs called PARP inhibitors take advantage of this to block the enzyme and prevent the cancer from coming back.

In this clinical trial, more than 1,800 patients with stage 2 to 3 breast cancer treated with surgery and chemotherapy were randomized to take 300 milligrams of olaparib or a placebo twice daily for one year.

Patients taking olaparib had a three-year invasive disease-free survival rate – no recurring breast cancer or other new cancers – of about 86%, compared to 77% for those taking a placebo, the results showed.

Dr Amy Tiersten is Professor of Hematology and Medical Oncology at the Icahn School of Medicine at Mount Sinai in New York. She said: “We have known for some time that PARP inhibitors have activity in patients with metastatic breast cancer, but this is the first time that we have seen efficacy in a setting. early stage. This study showed a substantial reduction in the risk of recurrence in this population and, therefore, the potential to cure more patients with early breast cancer associated with BRCA. “

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The side effects were consistent with previous studies of olaparib, Tutt said. The most serious common side effects included anemia, low white blood cell count, and fatigue.

Tutt said the study shows the importance of performing genetic testing on cancer patients, to look for traits and mutations that could be exploited to improve treatment and survival.

“There is definitely a case for a shift in the mindset in the community around where we use germline genetic testing,” Tutt said. “We have classically thought of this as something to do to determine a person’s risk of disease and maybe let other family members know if they have ever had it.”

Instead of just assessing risk, this genetic information can be used to save lives, Tutt noted.

Dr. Lori Pierce, president of the American Society of Clinical Oncology, agrees.

“This highlights the importance of genetic testing in the appropriate patients so that we know which patients will benefit from this therapy,” Pierce said. “I think it might even open the door to further trials of adjuvant PARP inhibitors for other cancers associated with BRCA1 and 2.”

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Olaparib can be an expensive drug. The cost of a supply of sixty 100-milligram tablets is just over $ 7,500, according to Drugs.com.

More information

The Dana-Farber Cancer Institute has more information on PARP inhibitors.

SOURCES: Andrew Tutt, MBChB, PhD, director, Breast Cancer Now Toby Robins Research Center, Institute of Cancer Research, London; Lori Pierce, MD, president, American Society for Clinical Oncology, Alexandria, Virginia; Amy Tiersten, MD, professor, hematology and medical oncology, Icahn School of Medicine in Mount Sinai, New York City; presentation, American Society of Clinical Oncology, June 3, 2021, online

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