Beas-Lozano Evelyn Lilian, Verduzco-Aguirre Haydeé Cristina, Gonzalez-Salazar Roberto, Chavarri-Guerra Yanin
Department of Hematology and Oncology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City 14630, Mexico.
Ecancermedicalscience. 2023 Nov 21;17:1633. doi: 10.3332/ecancer.2023.1633. eCollection 2023.
Breast cancer is the most common type of cancer globally. Hereditary breast cancer accounts for 10% of new cases and 4%-5% of cases are associated to pathogenic variants in or genes. In recent years, poly-adenosine-diphosphate-ribose polymerase inhibitors (PARPi) olaparib and talazoparib have been approved for patients with -associated, HER2 -negative breast cancer. These drugs have shown positive results in the early and advanced setting with a favourable toxicity profile based on the OlympiAD, OlympiA and EMBRACA phase 3 trials. However, patients included in these randomised trials are highly selected, making toxicity and efficacy in patients encountered in routine clinical care a concern. Since the approval of olaparib and talazoparib for advanced human epidermal growth factor receptor 2-negative (HER2-negative) breast cancer, several phase IIIb-IV trials, expanded access cohorts, and retrospective cohorts have provided information on the efficacy and tolerability of these treatments in patient subgroups underrepresented in the registration trials, such as older adults, patients with poor performance status, and heavily pretreated patients. The aim of this review is to present a critical review of the information regarding the use of PARPi in real-world breast cancer patients.
乳腺癌是全球最常见的癌症类型。遗传性乳腺癌占新发病例的10%,4%-5%的病例与BRCA1或BRCA2基因的致病性变异有关。近年来,聚腺苷二磷酸核糖聚合酶抑制剂(PARPi)奥拉帕利和他拉唑帕利已被批准用于治疗与BRCA相关的、人表皮生长因子受体2(HER2)阴性的乳腺癌患者。基于OlympiAD、OlympiA和EMBRACA 3期试验,这些药物在早期和晚期治疗中均显示出阳性结果,且毒性特征良好。然而,这些随机试验纳入的患者经过了高度筛选,这使得常规临床护理中患者的毒性和疗效成为一个问题。自从奥拉帕利和他拉唑帕利被批准用于治疗晚期人表皮生长因子受体2阴性(HER2阴性)乳腺癌以来,多项IIIb-IV期试验、扩大准入队列研究和回顾性队列研究提供了有关这些治疗方法在注册试验中代表性不足的患者亚组(如老年人、体能状态较差的患者和接受过大量预处理的患者)中的疗效和耐受性的信息。本综述的目的是对PARPi在现实世界乳腺癌患者中的应用信息进行批判性综述。