J Clin Oncol:携带PALB2胚系突变的乳腺癌患者也可从PARPi治疗中获益

2020-11-02 星云 MedSci原创

PARP抑制剂(PARPi)奥拉帕利(Olaparib)已获批用于治疗携带BRCA1/2胚系(germline,g)突变的HER2阴性的转移性乳腺癌(MBC)。奥拉帕利是否能用于携带BRCA1/2体系

PARP抑制剂(PARPi)奥拉帕利(Olaparib)已获批用于治疗携带BRCA1/2胚系(germline,g)突变的HER2阴性的转移性乳腺癌(MBC)。奥拉帕利是否能用于携带BRCA1/2体系(somatic,s)突变或除BRCA1/2以外的其他同源重组(HR)相关基因g/s突变的MBC患者尚不明确。

本研究是一项II期的奥拉帕利扩展研究,旨在评估奥拉帕利用于上述MBC患者的疗效。招募携带除BRCA1/2以外的HR相关基因胚系突变(队列1)或携带HR相关基因(包括BRCA1/2)体系突变(队列2)的MBC患者。要求患者既往未采用过PARPi治疗,非铂类难治性疾病或既往化疗后进展不超过两次。予以奥拉帕利 300 mg 口服(2/日)治疗直到病情进展。主要终点是客观缓解率(ORR),次要终点包括临床受益率和无进展存活期(PFS)。

共招募了54位患者。76%的患者为ER阳性、HER2阴性。87%的患者携带PALB2、sBRCA1/2、ATM或CHEK2突变。在队列1中,ORR为33%,在队列2中,ORR位31%。仅携带gPALB2 和sBRCA1/2突变的患者获得了缓解(ORR分别为82%和50%)。携带gPALB2的患者的中位PFS为13.3个月,携带sBRCA1/2突变的患者的为6.3个月。仅携带ATM或CHEK2突变的患者未见缓解。

PARP抑制可有效治疗携带gPALB2或SBRCA/2突变的MBC患者,极大的扩展了或可从PARPi治疗中获益的乳腺癌患者人群。该结果强调了分子特性在MBC治疗决策中的价值。

原始出处:

Nadine M. Tung, et al. TBCRC 048: Phase II Study of Olaparib for Metastatic Breast Cancer and Mutations in Homologous Recombination-Related Genes. Journal of Clinical Oncology. October 2020.

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    2020-11-04 lishiwen
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    2020-11-04 zhouqu_8
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    2020-11-03 146e4e40m72暂无昵称

    厉害

    0

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    2020-11-03 anti-cancer

    谢谢梅斯分享这么多精彩信息

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    2020-11-02 Terry tao

    厉害

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