TY - JOUR
T1 - Parp-inhibitors in the therapeutic landscape of breast cancer patients with BRCA1 and BRCA2 pathogenic germline variants
T2 - An Italian consensus paper and critical review
AU - Zambelli, Alberto
AU - Cortesi, Laura
AU - Gaudio, Mariangela
AU - Arpino, Grazia
AU - Bianchini, Giampaolo
AU - Caruso, Francesco
AU - Cinieri, Saverio
AU - Curigliano, Giuseppe
AU - Del Mastro, Lucia
AU - De Placido, Sabino
AU - Fabi, Alessandra
AU - Fortunato, Lucio
AU - Generali, Daniele
AU - Gennari, Alessandra
AU - Gori, Stefania
AU - Grandi, Giovanni
AU - Guarneri, Valentina
AU - Klinger, Marco
AU - Livi, Lorenzo
AU - Marchiò, Caterina
AU - Palumbo, Isabella
AU - Panizza, Pietro
AU - Pravettoni, Gabriella
AU - Pruneri, Giancarlo
AU - Puglisi, Fabio
AU - Sapino, Anna
AU - Tinterri, Corrado
AU - Turchetti, Daniela
AU - De Laurentiis, Michelino
N1 - Publisher Copyright:
© 2024 The Authors
PY - 2024/11
Y1 - 2024/11
N2 - 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.
AB - 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.
KW - BRCA
KW - Breast cancer
KW - Genetic testing
KW - Olaparib
KW - PARP-inhibitor
UR - http://www.scopus.com/inward/record.url?scp=85202688840&partnerID=8YFLogxK
U2 - 10.1016/j.ctrv.2024.102815
DO - 10.1016/j.ctrv.2024.102815
M3 - Review article
SN - 0305-7372
VL - 130
JO - Cancer Treatment Reviews
JF - Cancer Treatment Reviews
M1 - 102815
ER -