Difference between revisions of "Breast cancer, BRCA-mutated"
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*'''2011:''' [http://annonc.oxfordjournals.org/content/22/suppl_6/vi31.full.pdf+html BRCA in breast cancer: ESMO Clinical Practice Guidelines] [https://www.ncbi.nlm.nih.gov/pubmed/21908500 PubMed] | *'''2011:''' [http://annonc.oxfordjournals.org/content/22/suppl_6/vi31.full.pdf+html BRCA in breast cancer: ESMO Clinical Practice Guidelines] [https://www.ncbi.nlm.nih.gov/pubmed/21908500 PubMed] | ||
− | = | + | =Advanced or metastatic disease, all lines of therapy= |
==Olaparib monotherapy {{#subobject:a019cd|Regimen=1}}== | ==Olaparib monotherapy {{#subobject:a019cd|Regimen=1}}== | ||
{| class="wikitable" style="float:right; margin-left: 5px;" | {| class="wikitable" style="float:right; margin-left: 5px;" | ||
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*[[Olaparib (Lynparza)]] 100 mg PO BID | *[[Olaparib (Lynparza)]] 100 mg PO BID | ||
− | '''Continued | + | '''Continued indefinitely''' |
===Variant #2, 300 mg BID {{#subobject:3b0774|Variant=1}}=== | ===Variant #2, 300 mg BID {{#subobject:3b0774|Variant=1}}=== | ||
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*[[Olaparib (Lynparza)]] 400 mg PO BID | *[[Olaparib (Lynparza)]] 400 mg PO BID | ||
− | '''Continued | + | '''Continued indefinitely''' |
===References=== | ===References=== | ||
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# Kaufman B, Shapira-Frommer R, Schmutzler RK, Audeh MW, Friedlander M, Balmaña J, Mitchell G, Fried G, Stemmer SM, Hubert A, Rosengarten O, Steiner M, Loman N, Bowen K, Fielding A, Domchek SM. Olaparib monotherapy in patients with advanced cancer and a germline BRCA1/2 mutation. J Clin Oncol. 2015 Jan 20;33(3):244-50. Epub 2014 Nov 3. [http://jco.ascopubs.org/content/33/3/244.long link to original article] '''contains verified protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/25366685 PubMed] | # Kaufman B, Shapira-Frommer R, Schmutzler RK, Audeh MW, Friedlander M, Balmaña J, Mitchell G, Fried G, Stemmer SM, Hubert A, Rosengarten O, Steiner M, Loman N, Bowen K, Fielding A, Domchek SM. Olaparib monotherapy in patients with advanced cancer and a germline BRCA1/2 mutation. J Clin Oncol. 2015 Jan 20;33(3):244-50. Epub 2014 Nov 3. [http://jco.ascopubs.org/content/33/3/244.long link to original article] '''contains verified protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/25366685 PubMed] | ||
# '''OlympiAD:''' Robson M, Im SA, Senkus E, Xu B, Domchek SM, Masuda N, Delaloge S, Li W, Tung N, Armstrong A, Wu W, Goessl C, Runswick S, Conte P. Olaparib for metastatic breast cancer in patients with a germline BRCA mutation. N Engl J Med. 2017 Aug 10;377(6):523-533. Epub 2017 Jun 4. [http://www.nejm.org/doi/full/10.1056/NEJMoa1706450 link to original article] '''contains verified protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/28578601 PubMed] | # '''OlympiAD:''' Robson M, Im SA, Senkus E, Xu B, Domchek SM, Masuda N, Delaloge S, Li W, Tung N, Armstrong A, Wu W, Goessl C, Runswick S, Conte P. Olaparib for metastatic breast cancer in patients with a germline BRCA mutation. N Engl J Med. 2017 Aug 10;377(6):523-533. Epub 2017 Jun 4. [http://www.nejm.org/doi/full/10.1056/NEJMoa1706450 link to original article] '''contains verified protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/28578601 PubMed] | ||
+ | |||
+ | ==Talazoparib monotherapy {{#subobject:bb55eb|Regimen=1}}== | ||
+ | {| class="wikitable" style="float:right; margin-left: 5px;" | ||
+ | |- | ||
+ | |[[#top|back to top]] | ||
+ | |} | ||
+ | ===Regimen {{#subobject:06a5b4|Variant=1}}=== | ||
+ | {| class="wikitable" style="color:white; background-color:#404040" | ||
+ | |<small>'''FDA-recommended dose'''</small> | ||
+ | |- | ||
+ | |} | ||
+ | {| class="wikitable" style="width: 100%; text-align:center;" | ||
+ | !style="width: 25%"|Study | ||
+ | !style="width: 25%"|[[Levels_of_Evidence#Evidence|Evidence]] | ||
+ | !style="width: 25%"|Comparator | ||
+ | !style="width: 25%"|[[Levels_of_Evidence#Efficacy|Efficacy]] | ||
+ | |- | ||
+ | |[https://www.nejm.org/doi/full/10.1056/NEJMoa1802905 Litton et al. 2018 (EMBRACA)] | ||
+ | | style="background-color:#1a9851" |Phase III (E) | ||
+ | |Physician's choice of:<br> 1. Capecitabine<br> 2. Eribulin<br> 3. Gemcitabine<br> 4. Vinorelbine | ||
+ | | style="background-color:#1a9850" |Superior PFS | ||
+ | |- | ||
+ | |} | ||
+ | ====Chemotherapy==== | ||
+ | *[[Talazoparib (Talzenna)]] 1 mg PO once per day | ||
+ | |||
+ | '''Continued indefinitely''' | ||
+ | |||
+ | ===References=== | ||
+ | # '''EMBRACA:''' Litton JK, Rugo HS, Ettl J, Hurvitz SA, Gonçalves A, Lee KH, Fehrenbacher L, Yerushalmi R, Mina LA, Martin M, Roché H, Im YH, Quek RGW, Markova D, Tudor IC, Hannah AL, Eiermann W, Blum JL. Talazoparib in patients with advanced breast cancer and a germline BRCA mutation. N Engl J Med. 2018 Aug 23;379(8):753-763. Epub 2018 Aug 15. [https://www.nejm.org/doi/full/10.1056/NEJMoa1802905 link to original article] '''contains protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/30110579 PubMed] | ||
=Additional resources= | =Additional resources= |
Revision as of 02:17, 17 October 2018
10 regimens on this page
13 variants on this page
|
Note: this page has regimens which are specific to breast cancer that is BRCA-mutated. Please see the main breast cancer page for other chemotherapy regimens.
Guidelines
ESMO
Advanced or metastatic disease, all lines of therapy
Olaparib monotherapy
back to top |
Variant #1, 100 mg BID
Study | Evidence |
---|---|
Tutt et al. 2010 | Phase II |
Chemotherapy
- Olaparib (Lynparza) 100 mg PO BID
Continued indefinitely
Variant #2, 300 mg BID
Study | Evidence | Comparator | Efficacy |
---|---|---|---|
Robson et al. 2017 (OlympiAD) | Phase III (E) | 1. Capecitabine 2. Eribulin 3. Vinorelbine |
Superior PFS |
Patients had confirmed deleterious or suspected deleterious germline BRCA mutation. This is the FDA-approved dose.
Chemotherapy
- Olaparib (Lynparza) 300 mg PO BID
Continued indefinitely
Variant #3, 400 mg BID
Study | Evidence |
---|---|
Tutt et al. 2010 | Phase II |
Kaufman et al. 2014 | Phase II |
Patients in Kaufman et al. 2014 had germline BRCA1/2 mutations and had progressed after at least three lines of treatment for metastatic disease.
Chemotherapy
- Olaparib (Lynparza) 400 mg PO BID
Continued indefinitely
References
- Tutt A, Robson M, Garber JE, Domchek SM, Audeh MW, Weitzel JN, Friedlander M, Arun B, Loman N, Schmutzler RK, Wardley A, Mitchell G, Earl H, Wickens M, Carmichael J. Oral poly(ADP-ribose) polymerase inhibitor olaparib in patients with BRCA1 or BRCA2 mutations and advanced breast cancer: a proof-of-concept trial. Lancet. 2010 Jul 24;376(9737):235-44. Epub 2010 Jul 6. link to original article PubMed
- Kaufman B, Shapira-Frommer R, Schmutzler RK, Audeh MW, Friedlander M, Balmaña J, Mitchell G, Fried G, Stemmer SM, Hubert A, Rosengarten O, Steiner M, Loman N, Bowen K, Fielding A, Domchek SM. Olaparib monotherapy in patients with advanced cancer and a germline BRCA1/2 mutation. J Clin Oncol. 2015 Jan 20;33(3):244-50. Epub 2014 Nov 3. link to original article contains verified protocol PubMed
- OlympiAD: Robson M, Im SA, Senkus E, Xu B, Domchek SM, Masuda N, Delaloge S, Li W, Tung N, Armstrong A, Wu W, Goessl C, Runswick S, Conte P. Olaparib for metastatic breast cancer in patients with a germline BRCA mutation. N Engl J Med. 2017 Aug 10;377(6):523-533. Epub 2017 Jun 4. link to original article contains verified protocol PubMed
Talazoparib monotherapy
back to top |
Regimen
FDA-recommended dose |
Study | Evidence | Comparator | Efficacy |
---|---|---|---|
Litton et al. 2018 (EMBRACA) | Phase III (E) | Physician's choice of: 1. Capecitabine 2. Eribulin 3. Gemcitabine 4. Vinorelbine |
Superior PFS |
Chemotherapy
- Talazoparib (Talzenna) 1 mg PO once per day
Continued indefinitely
References
- EMBRACA: Litton JK, Rugo HS, Ettl J, Hurvitz SA, Gonçalves A, Lee KH, Fehrenbacher L, Yerushalmi R, Mina LA, Martin M, Roché H, Im YH, Quek RGW, Markova D, Tudor IC, Hannah AL, Eiermann W, Blum JL. Talazoparib in patients with advanced breast cancer and a germline BRCA mutation. N Engl J Med. 2018 Aug 23;379(8):753-763. Epub 2018 Aug 15. link to original article contains protocol PubMed