La terapia sistemica antitumorale: quali novità nel setting … · 2019-10-07 · Conclusions...

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Roma, 4 Ottobre 2019 Relatore: Francesca Poggio U.O. Oncologia Medica 2 IRCCS Ospedale Policlinico S. Martino, Genova 2019 CARCINOMA MAMMARIO: I TRAGUARDI RAGGIUNTI E LE NUOVE SFIDE La terapia sistemica antitumorale: quali novità nel setting (neo)adiuvante? Sessione 4: Il carcinoma mammario nelle donne con mutazione patogenetica BRCA1-2

Transcript of La terapia sistemica antitumorale: quali novità nel setting … · 2019-10-07 · Conclusions...

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Roma, 4 Ottobre 2019

Relatore: Francesca Poggio

U.O. Oncologia Medica 2 IRCCS Ospedale Policlinico S. Martino, Genova

2019 CARCINOMA MAMMARIO: I TRAGUARDI RAGGIUNTI E LE NUOVE SFIDE

La terapia sistemica antitumorale: quali novità nel setting (neo)adiuvante?

Sessione 4: Il carcinoma mammario nelle donne con mutazione patogenetica BRCA1-2

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Disclosure Information Relationship Relevant to this Session

Poggio, Francesca:

No relevant relationship to disclose.

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• Introduction

• Neoadjuvant: platinum agents • Neoadjuvant: PARPi • (Neo)Adjuvant setting: ongoing trials

• Conclusions

Agenda

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BRCA mutations carriers: The POSH study

POSH is the largest prospective cohort study to compare breast cancer

outcomes of patients with a BRCA1 or BRCA2 mutation with patients with

sporadic cancer.

Our findings showed that patients with young-onset breast cancer who have

a BRCA mutation have a similar overall survival to non-carriers. Copson ER, Lancet 2018

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BRCA mutations carriers: Guidelines

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• Introduction

• Neoadjuvant: platinum agents • Neoadjuvant: PARPi • (Neo)Adjuvant setting: ongoing trials

• Conclusions

Agenda

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Neoadjuvant setting: Geparsixto

Hahnen E, JAMA Oncol 2017

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Neoadjuvant setting: BrighTNess

Loibl S, Lancet 2018

~15% mBRCA

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Neoadjuvant setting: BrighTNess

Loibl S, Lancet 2018

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Neoadjuvant setting: BrighTNess

Loibl S, Lancet 2018

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Meta-analysis platinum agents

∆pCR 15%!

Poggio F, Ann Oncol 2018

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Meta-analysis platinum agents

BRCA-mutated patients

BRCA-negative patients

Poggio F, Ann Oncol 2018

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• Introduction

• Neoadjuvant: platinum agents • Neoadjuvant: PARPi • (Neo)Adjuvant setting: ongoing trials

• Conclusions

Agenda

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PARPi single agent

Litton J, J Clin Oncol 2019

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First study of a single targeted therapy to achieve pCR in BRCA+ patients, including TNBC Talazoparib was well tolereted with acceptable adherence This study warrants the larger confirmatory trial

PARPi single agent: results

Litton J, J Clin Oncol 2019

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GeparOla

Fasching AP, J Clin Oncol 2019

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GeparOla: results

Fasching AP, J Clin Oncol 2019

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GeparOla: results

Fasching AP, J Clin Oncol 2019

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GeparOla: results

Fasching AP, J Clin Oncol 2019

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(Neo)adjuvant setting

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• Introduction

• Neoadjuvant: platinum agents • Neoadjuvant: PARPi • (Neo)Adjuvant setting: ongoing trials

• Conclusions

Agenda

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PARPi in the adj setting OlympiA trial

Prior (neo)adjuvant platinum allowed

Recently completed 1836 BRCA carriers enrolled

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INFORM trial: perioperative CDDP vs. AC

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• Introduction

• Neoadjuvant: platinum agents • Neoadjuvant: PARPi • (Neo)Adjuvant setting: ongoing trials

• Conclusions

Agenda

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Conclusions

• How big is the issue: nearly 6% of all BC and nearly 15%

in the subgroup ≤ 45 years or TNBC regardless the age • Current guidelines did not recommend a specific

treatment for BRCA-mutated in the early setting • Tha addition of platinum to neoadjuvant chemotherapy

may be considered an option for unselected TNBC • Results of ongoing trials are awaited to clarify the role

of PARPi in the (neo)adjuvant setting


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