Clinical Considerations for the Integration of Adjuvant Olaparib into Practice for Early Breast Cancer: A Canadian Perspective

Jan-Willem Henning; Jean-François Boileau; Larissa Peck; Tom McFarlane

doi:10.3390/curroncol30080556

Clinical Considerations for the Integration of Adjuvant Olaparib into Practice for Early Breast Cancer: A Canadian Perspective

Curr Oncol. 2023 Aug 17;30(8):7672-7691. doi: 10.3390/curroncol30080556.

Authors

Jan-Willem Henning¹, Jean-François Boileau², Larissa Peck³, Tom McFarlane⁴

Affiliations

¹ Tom Baker Cancer Centre, University of Calgary, Calgary, AB T2N 4N2, Canada.
² Segal Cancer Centre, Jewish General Hospital, McGill University, Montreal, QC H3T 1E2, Canada.
³ Princess Margaret Cancer Centre, Toronto, ON M5G 2M9, Canada.
⁴ Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, Canada.

Abstract

With the recent Health Canada approval of olaparib for high-risk, HER2-negative early breast cancer, physicians are now facing the practical challenges of integrating olaparib into current management of triple-negative breast cancer (TNBC) and HR-positive, HER2-negative (HR+/HER2-) early breast cancer. This review provides perspectives on some of the challenges related to identification of olaparib candidates, with a focus on the latest guidance for germline BRCA testing and considerations regarding high-risk disease definitions. Updated treatment pathways are explored for both disease states, including other adjuvant treatment options such as pembrolizumab, capecitabine, and abemaciclib. Gaps in the current literature regarding the sequential or combined use of these adjuvant therapies are noted and future, potentially informative, studies are briefly examined.

Keywords: BRCA; adjuvant therapy; capecitabine; early-stage breast cancer; genetic testing; olaparib; pembrolizumab; poly(ADP-ribose) polymerase inhibitors.

Publication types

Review
Research Support, Non-U.S. Gov't

MeSH terms

Canada
Humans
Phthalazines* / therapeutic use
Piperazines / therapeutic use
Triple Negative Breast Neoplasms*

Substances

olaparib
Phthalazines
Piperazines

Grants and funding

Funding was provided by AstraZeneca Canada to support medical writing and administrative coordination of this manuscript. The funder did not contribute to the content or writing of the manuscript.