Parp-inhibitors in the therapeutic landscape of breast cancer patients with BRCA1 and BRCA2 pathogenic germline variants: An Italian consensus paper and critical review

被引:1
作者
Zambelli, Alberto [1 ,2 ]
Cortesi, Laura [3 ]
Gaudio, Mariangela [1 ,2 ]
Arpino, Grazia [4 ]
Bianchini, Giampaolo [5 ,6 ]
Caruso, Francesco [7 ]
Cinieri, Saverio [8 ,9 ]
Curigliano, Giuseppe [10 ,11 ]
Del Mastro, Lucia [12 ,13 ]
De Placido, Sabino [14 ]
Fabi, Alessandra [15 ]
Fortunato, Lucio [16 ]
Generali, Daniele [17 ,18 ]
Gennari, Alessandra [19 ,20 ]
Gori, Stefania [21 ]
Grandi, Giovanni [22 ]
Guarneri, Valentina [23 ,24 ]
Klinger, Marco [25 ]
Livi, Lorenzo [26 ]
Marchio, Caterina [27 ,28 ]
Palumbo, Isabella [29 ,30 ]
Panizza, Pietro [31 ]
Pravettoni, Gabriella [32 ]
Pruneri, Giancarlo [33 ,34 ]
Puglisi, Fabio [35 ,36 ]
Sapino, Anna [28 ]
Tinterri, Corrado [1 ,37 ]
Turchetti, Daniela [38 ,39 ]
De Laurentiis, Michelino [40 ]
机构
[1] Humanitas Univ, Dept Biomed Sci, Via Rita Levi Montalcini 4, I-20090 Milan, Italy
[2] Humanitas Clin & Res Ctr, IRCCS, Humanitas Canc Ctr, Via Manzoni 56, I-20089 Milan, Italy
[3] Univ Hosp Modena, Dept Oncol & Hematol, Via Pozzo 71, I-41124 Modena, Italy
[4] Univ Federico II, Dept Clin Med & Surg, Naples, Italy
[5] IRCCS San Raffaele Hosp, Dept Med Oncol, Milan, Italy
[6] Univ Vita Salute San Raffaele, Milan, Italy
[7] Humanitas Hosp, Breast Unit Surg, Via Vittorio Emanuele da Bormida 64, Catania, Italy
[8] Osped Perrino, UOC Oncol Med & Breast Unit, Brindisi, Italy
[9] Fdn AIOM, Milan, Italy
[10] Ist Europeo Oncol, IRCCS, Milan, Italy
[11] Univ Milan, Dipartimento Oncol Emato Oncol, Milan, Italy
[12] Univ Genoa, Sch Med, Dept Internal Med & Med Specialties DiMI, Genoa, Italy
[13] Osped Policlin San Martino, Dept Med Oncol, UO Clin Oncol Med, IRCCS, Genoa, Italy
[14] Univ Naples Federico II, Dept Clin Med & Surg, Naples, Italy
[15] Fdn Policlin Univ A Gemelli IRCCS, Precis Med Unit Senol, Rome, Italy
[16] San Giovanni Addolorata Hosp, Breast Ctr, Dept Surg, Rome, Italy
[17] Azienda Socio Sanit Terr Cremona, Breast Canc Unit, Cremona, Italy
[18] Univ Trieste, Dept Med Surg & Hlth Sci, Trieste, Italy
[19] Univ Piemonte Orientale, Dept Traslat Med, Novara, Italy
[20] Maggiore Univ Hosp, Div Med Oncol, Novara, Italy
[21] IRCCS Sacro Cuore Don Calabria, Med Oncol, Negrar Di Valpolicella, VR, Italy
[22] Univ Modena & Reggio Emilia, Dept Med & Surg Sci Mother Child & Adult, Azienda Osped Univ Modena, Modena, Italy
[23] Univ Padua, Dept Surg Oncol & Gastroenterol, Padua, Italy
[24] Ist Oncol Veneto IRCCS, Oncol2, Padua, Italy
[25] Univ Milan, Humanitas Clin & Res Hosp, Reconstruct & Aesthet Plast Surg Sch, Dept Med Biotechnol & Translat Med BIOMETRA,Plast, Milan, Italy
[26] Univ Florence, Radiat Oncol Unit, Azienda Ospedaliero Universitaria Careggi, Florence, Italy
[27] Univ Turin, Dept Med Sci, Turin, Italy
[28] Candiolo Canc Inst, Pathol Unit, FPO IRCCS, Candiolo, Italy
[29] Univ Perugia, Radiat Oncol Sect, Perugia, Italy
[30] Perugia Gen Hosp, Perugia, Italy
[31] IRCCS Osped San Raffaele, Breast Imaging Unit, Milan, Italy
[32] Univ Milan, Ist Europeo Oncol, Dept Oncol & Haematol, Appl Res Div Cognit & Psychol Sci,IRCCS, Milan, Italy
[33] Fdn IRCCS, Ist Nazl Tumori, Dept Adv Diagnost, Milan, Italy
[34] Univ Milan, Sch Med, Dept Oncol & Hematooncol, Milan, Italy
[35] Univ Udine, Dept Med, Udine, Italy
[36] Ctr riferimento Oncol, Dept Med Oncol, Unit Med Oncol & Canc Prevent, IRCCS, Aviano, Italy
[37] Humanitas Res Hosp, Breast Unit, Milan, Italy
[38] Univ Bologna, Dept Med & Surg Sci DIMEC, Bologna, Italy
[39] IRCCS Azienda Osped Univ Bologna, Med Genet Unit, Bologna, Italy
[40] Ist Nazl Tumori IRCCS Fdn G Pascale, Div Breast Med Oncol, Naples, Italy
关键词
Breast cancer; BRCA; Genetic testing; Olaparib; PARP-inhibitor; PEMBROLIZUMAB PLUS CHEMOTHERAPY; MUTATION CARRIERS; OPEN-LABEL; RISK; SURVIVAL; OLAPARIB; OVARIAN; GENES;
D O I
10.1016/j.ctrv.2024.102815
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
The introduction of PARP inhibitors has revolutionized the management and treatment of patients with pathogenic germline variants of BRCA1/2 who have developed breast cancer. The implementation of PARP inhibitors in clinical settings can be challenging due to their overlapping indications with other drugs, including both recently approved medications and those with proven efficacy. This study utilized the Delphi method to present the first Italian consensus regarding genetic testing, the use of PARP inhibitors in both early and metastatic settings, and strategies for managing the potential toxicity of these novel drugs. The Panel unanimously agreed on various issues, including the timing, techniques, and patient characteristics for BRCA1/2 genetic testing, and the appropriate placement of PARP inhibitors in the treatment algorithm for both early and advanced breast cancer. Nevertheless, some areas of divergence became evident, particularly regarding the use of axillary surgery for therapeutic purposes and the application of hormone replacement therapy in cases of bilateral mastectomy and risk-reducing salpingo-oophorectomy for patients treated for triple negative breast cancer. Additional research is needed in these particular domains to improve the care of patients with breast cancer who bear an increased genetic risk.
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页数:10
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