Biotech Strategy Blog

Commentary on Science, Innovation & New Products with a focus on Oncology, Hematology & Immunotherapy

Posts tagged ‘early stage breast cancer’

How – and when – should people with early stage breast cancer be treated with a PARP inhibitor?

We’re going to take a change of pace from our scientific previews from the forthcoming AACR meeting and switch to early stage cancer clinical trials readouts coming out this week.

The first one on deck is an update of the OlympiA trial exploring the PARP inhibitor olaparib as adjuvant therapy after chemotherapy in early stage germline BRCA mutation-positive (gBRCAm) high-risk breast cancer.

This is an important trial to follow given it’s the first of the PARPs to read out in early stage breast cancer in a well defined patient population with a high risk of disease recurrence.

Here, we explore the pros and cons of the latest findings and also put them in context since there’s quite a few important nuances to consider…

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Is olaparib scaling new heights in OlympiA?

Source: Wikipedia

We first wrote about the fascinating and complex space way of synthetic lethality and PARP inhibition way back in 2006 when the early preclinical developments and targets were just emerging and finally here we are – 15 years later – with the very first phase 3 data in the adjuvant setting.

It’s not often I get to highlight someone and their extensive research from my alma mater, but it’s a delightful opportunity to put it on the front page for a change. The gritty urban setting is a far cry from the romance of the other Kings College (in Cambridge), although the two cities do overlap somewhat in this particular story.

What can we learn from the latest clinical development in early stage breast cancer and what don’t we yet know?

There’s actually quite a lot to ponder and digest here…

BSB subscribers can read more on our initial perspectives regarding PARP inhibition in early stage breast cancer and the OlympiA trial, subscribers can log-in or you can click to read our ASCO21 coverage.

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Insights from KEYNOTE-522 in early stage TNBC

Cui bono?

Imagine arriving at ESMO19 at the crack of dawn for a press briefing and you’re not presenting until after 4.30pm!

To whom is it a benefit is a fundamental principle in modern day medicine given the often vast array of options that oncologists may have at their disposal.

Conversely, we also need to know nec refert – for whom it doesn’t matter or doesn’t benefit – since we don’t want to over-treat people either.

Between those two extremes might be a couple of sweetspots i.e. one subset who may need a boost from chemotherapy and another in whom chemo plus IO therapy might be a better option.

For sure, we are not advocating that all people with early stage triple negative breast cancer (TNBC) should receive the same thing and certainly not everyone will need checkpoint therapy, no matter what the intent-to-treat (ITT) curves or response rates might try to imply.

There’s a lot of factors to think about and consider so here we look at the KEYNOTE–522 data in neoadjuvant and adjuvant TNBC and unearthed with some solid evidence that might help us understand and think about what needs to be done.

Following on from our in-depth ESMO19 Preview on TNBC and what to watch out for, we also now have a thought leader interview to share plus several other commentators chipping in…

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