Reducing Breast Cancer Recurrence for Patients with BRCA1 or BRCA2 Gene Mutations

Approximately 5% of all breast cancer patients have a BRCA1 or BRCA2 gene mutation, which equates to roughly 1,000 women diagnosed with breast cancer in Australia each year.

BCT Study Chair of the OlympiA trial Professor Kelly-Anne Phillips with trial participant Dimity Paul.

These women are typically diagnosed with breast cancer at a younger age and often have a particularly aggressive form of breast cancer.

The OlympiA clinical trial has identified a new treatment for patients with early-stage breast cancer that have a genetic mutation in the BRCA1 or BRCA2 genes, that may help prevent their breast cancer returning and cancer spreading, after their initial treatment has been completed.

OlympiA was led in Australia by Breast Cancer Trials Study Chair Professor Kelly-Anne Phillips and was coordinated internationally by the Breast International Group. The study recruited 1,836 patients worldwide, including 60 women from 12 participating institutions throughout Australia.

This was a phase III clinical trial, which tested the efficacy and safety of olaparib tablets versus a placebo.

Results from the OlympiA clinical trial shows that olaparib reduces breast cancer recurrence by 42% in patients with early-stage breast cancer who have a BRCA1 or BRCA2 gene mutation.

OlympiA found that giving olaparib tablets twice daily for a year to patients with BRCA1 and BRCA2 mutations, after they have completed chemotherapy, increases the chances that they will remain free of invasive or metastatic cancer.

Professor Phillips says the results provide a new treatment option for patients with early-stage breast cancer.

“One of the biggest fears that patients have is that their breast cancer will come back. Olaparib exploits an inherent defect in DNA repair that is present in the cancers of people with a BRCA1 or BRCA2 mutation, ensuring that cancer cells are more likely to die. Our study findings are a significant step forward in the precision treatment of breast cancer and provides a new treatment option.”

“The findings also mean that genetic testing for BRCA1 and BRCA2 will likely become more routine for all women with newly diagnosed breast cancer. This will have the downstream effect of helping us to identify their relatives who also have the gene abnormality and who can therefore undertake evidence-based treatments that can prevent them getting cancer. So this is not only a step forward in breast cancer treatment, but also in helping us to prevent cancer.”

Publication

Tutt ANJ, Garber JE, Kaufman B, Viale G, Fumagalli D, Rastogi P, Gelber RD, de Azambuja E, Fielding A, Balmana J, Domchek SM, Gelmon KA, Hollingsworth SJ, Dorde LA, Linderholm B, Bandos H, Senkus E, Suga JM, Shao Z, Pippas AW, Nowecki Z, Huzarski T, Ganz PA, Lucas BC, Baker N, Loibl S, McConnell R, Piccart M, Schmutzler R, Steger GG, Costantino JP, Arahmani A, Wolmarck N, McFadden E, Karantza V, Lakhani SR, Yothers G, Campbell C, Geyer Jr CE, for the OlympiA Steering Committee and Investigators Adjuvant Olaparib for Patients with BRCA1- or BRCA2-Mutated Breast Cancer. New England Journal of Medicine. 2021; 384 (22) epub 03 June 2021 https://www.nejm.org/doi/full/10.1056/NEJMoa210521