A Shift in the Standard of Care
For many patients and clinicians, navigating the uncertainty of high-risk, early-stage breast cancer is a journey marked by a search for every possible advantage against recurrence. In 2020, the American Society of Clinical Oncology (ASCO) published guidelines regarding the management of hereditary breast cancer that reflected the reality of the time: there was "insufficient data" to recommend poly(ADP–ribose) polymerase (PARP) inhibitors for patients with nonmetastatic disease.
However, the landscape of oncology moves swiftly. By June 2021, practice-changing data emerged, prompting an ASCO "Rapid Recommendation Update." This transition from a stance of "insufficient data" to a clear clinical recommendation represents a major milestone. We are no longer waiting for evidence; we are applying it. This blog explores how adjuvant olaparib—a targeted PARP inhibitor—is providing a new shield for patients with early-stage, HER2-negative breast cancer and germline BRCA mutations.
To ensure clarity for all members of the care team, it is important to define our terms: therapy refers to treatment given after the primary treatment (usually surgery) to lower the risk of the cancer returning, while therapy refers to treatment (like chemotherapy) given before surgery to shrink a tumor.