30 May 2024 | Jean E. Abraham, Karen Pinilla, Alimu Dayim, Louise Grybowicz, Nikolaos Demiris, Caron Harvey, Lynsey M. Drewett, Rebecca Lucey, Alexander Fulton, Anne N. Roberts, Joanna R. Worley, Anita Chhabra, Wendi Qian, Anne-Laure Vallier, Richard M. Hardy, Steve Chan, Tamas Hickish, Devashish Tripathi, Ramachandran Venkitaraman, Mojca Percic, 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. Chur, Jacqueline C. Newby, Mukesh B. Mukesh, Amitabha Chakrabarti, Rebecca A. Royland, 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 carboplatin-paclitaxel with or without olaparib (150 mg twice daily for 12 days) followed by anthracycline-based chemotherapy. 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 between the groups. EFS at 36 months was 80% in both arms, and OS was 90% and 87.2%, respectively. In patients with pCR, EFS was 90% and OS was 96%, while in those without pCR, EFS was 70% and OS was 83%. Neoadjuvant olaparib did not improve pCR rates, EFS, or OS when added to chemotherapy in gBRCAwt TNBC patients. The trial found no significant benefit of olaparib in this population, contrasting with its effectiveness in gBRCAm patients. Safety and toxicity were comparable between arms, with higher rates of grade 3 or 4 adverse events in the research arm. Quality of life was slightly better in the control arm. The trial highlights the importance of identifying biomarkers for TNBC(gBRCAwt) and underscores the need for further research into targeted therapies for this group. The results suggest that olaparib may not be effective in gBRCAwt TNBC, despite its potential in gBRCAm patients. The study provides insights into the biology of TNBC(gBRCAwt) and may inform future precision medicine approaches.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 carboplatin-paclitaxel with or without olaparib (150 mg twice daily for 12 days) followed by anthracycline-based chemotherapy. 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 between the groups. EFS at 36 months was 80% in both arms, and OS was 90% and 87.2%, respectively. In patients with pCR, EFS was 90% and OS was 96%, while in those without pCR, EFS was 70% and OS was 83%. Neoadjuvant olaparib did not improve pCR rates, EFS, or OS when added to chemotherapy in gBRCAwt TNBC patients. The trial found no significant benefit of olaparib in this population, contrasting with its effectiveness in gBRCAm patients. Safety and toxicity were comparable between arms, with higher rates of grade 3 or 4 adverse events in the research arm. Quality of life was slightly better in the control arm. The trial highlights the importance of identifying biomarkers for TNBC(gBRCAwt) and underscores the need for further research into targeted therapies for this group. The results suggest that olaparib may not be effective in gBRCAwt TNBC, despite its potential in gBRCAm patients. The study provides insights into the biology of TNBC(gBRCAwt) and may inform future precision medicine approaches.