The PARTNER trial of neoadjuvant olaparib with chemotherapy in triple-negative breast cancer

The PARTNER trial of neoadjuvant olaparib with chemotherapy in triple-negative breast cancer

8 April 2024 | Jean E. Abraham, Karen Pinilla, Alimu Dayimu, Louise Grybowicz, Nikolaos Demiris, Caron Harvey, Lynsey M. Drewett, Rebecca Lucey, Alexander Fulton, Anne N. Roberts, Joanna R. Howley, Anita Chhabra, Wendi Qian, Anne-Laure Vallier, Richard M. Hardy, Steve Chan, Tamas Hickish, Devashish Tripathi, Ramachandran Venkitaramanan, Mojca Persic, Shahzeena Aslam, Daniel Glassman, Sanjay Raj, Annabel Borley, Jeremy P. Braybrooke, Stephanie Sutherland, Emma Staples, Lucy C. Scott, Mark Davies, Cheryl A. Palmer, Margaret Moody, Mark J. Churm, Jacqueline C. Newby, Mukesh B. Mukesh, Amitabha Chakrabarti, Rebecca R. Roylance, Philip C. Schouten, Nicola C. Levitt, Karen McAdam, Anne C. Armstrong, Ellen R. Copson, Emma McMurry, Marc Tischkowitz, Elena Provenzano, Helena M. Earl
The PARTNER trial evaluated the addition of olaparib to neoadjuvant chemotherapy in patients with triple-negative breast cancer (TNBC) who were germline BRCA1 and BRCA2 wild type (gBRCAwt). Patients were randomized to receive either neoadjuvant carboplatin–paclitaxel with or without olaparib (150 mg twice daily for 12 days, gap schedule). Following this, they received three cycles of anthracycline-based chemotherapy before surgery. The primary endpoint was pathologic complete response (pCR), with secondary endpoints including event-free survival (EFS) and overall survival (OS). pCR rates were 51% in the research arm and 52% in the control arm, with no significant difference. EFS and OS at 36 months were similar between the arms. Neoadjuvant olaparib did not improve pCR rates, EFS, or OS compared to chemotherapy alone in gBRCAwt TNBC patients. The trial also explored the potential of olaparib in gBRCAwt TNBC, which may have homologous recombination deficiency, and found that olaparib did not show significant benefit in this group. The trial demonstrated that olaparib was well tolerated, with no significant differences in treatment discontinuation due to toxicity between groups. However, more patients in the research arm required blood transfusions due to anaemia. The study highlights the importance of rapid assessment of germline BRCA pathogenic variants in TNBC patients to guide treatment. The results suggest that olaparib may not be effective in gBRCAwt TNBC, but may benefit patients with germline BRCA mutations. The trial also emphasizes the need for further research into biomarkers that could predict response to olaparib in TNBC patients. The study provides valuable insights into the treatment of TNBC and the role of PARP inhibitors in this patient population.The PARTNER trial evaluated the addition of olaparib to neoadjuvant chemotherapy in patients with triple-negative breast cancer (TNBC) who were germline BRCA1 and BRCA2 wild type (gBRCAwt). Patients were randomized to receive either neoadjuvant carboplatin–paclitaxel with or without olaparib (150 mg twice daily for 12 days, gap schedule). Following this, they received three cycles of anthracycline-based chemotherapy before surgery. The primary endpoint was pathologic complete response (pCR), with secondary endpoints including event-free survival (EFS) and overall survival (OS). pCR rates were 51% in the research arm and 52% in the control arm, with no significant difference. EFS and OS at 36 months were similar between the arms. Neoadjuvant olaparib did not improve pCR rates, EFS, or OS compared to chemotherapy alone in gBRCAwt TNBC patients. The trial also explored the potential of olaparib in gBRCAwt TNBC, which may have homologous recombination deficiency, and found that olaparib did not show significant benefit in this group. The trial demonstrated that olaparib was well tolerated, with no significant differences in treatment discontinuation due to toxicity between groups. However, more patients in the research arm required blood transfusions due to anaemia. The study highlights the importance of rapid assessment of germline BRCA pathogenic variants in TNBC patients to guide treatment. The results suggest that olaparib may not be effective in gBRCAwt TNBC, but may benefit patients with germline BRCA mutations. The trial also emphasizes the need for further research into biomarkers that could predict response to olaparib in TNBC patients. The study provides valuable insights into the treatment of TNBC and the role of PARP inhibitors in this patient population.
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