Treatment with olaparib for BRCA pathogenic variant-positive metastatic breast cancer at our hospital

Abstract

　In July 2018, Olaparib, a poly adenosine diphosphate ribose polymerase（PARP）inhibitor, was indicated for patients with HER2-negative BRCA pathogenic variant-positive metastatic breast cancer. At the same time, BRCA genetic testing was approved as companion diagnostics to determine whether olaparib can be used as a treatment for breast cancer. By April 2019, 38 BRCA genetic tests had been performed at our hospital, and seven of these had confirmed pathogenic variants. Five patients were treated with olaparib and achieved therapeutic effects. These effects did not depend on the number of regimens before the treatment with Olaparib. However, in some cases, the treatment period lasted for >1 year, and other cases had progressive disease（PD）within about 6 months. Although side effects such as progression of anemia and gastrointestinal symptoms have been reported, they were within the manageable range in our cases. Since therapeutic effects are expected with a few side effects， genetic testing should be performed on candidate patients. However, not all patients have long-term therapeutic effects, therefore, treatment other than olaparib should be considered.