Health. Triple-negative breast cancer: This medication taken before surgery could change everything

Triple negative breast cancer affects nearly 15% of the 61,000 breast cancer patients diagnosed each year in France.

Very aggressive, it is also particularly difficult to treat because it is insensitive to hormonal treatments - estrogens and progesterones - and to treatments targeting the HER 2 protein; this is why it has been called "triple negative".

The disease, which has a poor prognosis, often affects young women who have a genetic predisposition (hereditary BRCA1 and BRCA2 mutations).

Currently, the standard treatment involves shrinking the tumor with chemotherapy and immunotherapy, followed by surgical removal. The following three years are crucial, with high risks of death and recurrence.

100% of patients survived 3 years after surgery

A new therapeutic approach could revolutionize the treatment of triple-negative cancers. The Partner trial, led by researchers at the University of Cambridge (England), tested the addition of Olaparib to chemotherapy before surgery.

This drug has already shown some effectiveness post-operatively, to prevent recurrences in women carrying the BRCA mutation.

In the UK, it is prescribed to patients for 12 months after surgery. In this trial, participants took it for the 12 weeks before surgery.

The drug was administered before surgery, 48 hours after chemotherapy. According to the results, published May 13 in the journal Nature Communications , of the 39 patients who underwent chemotherapy and took Olaparib, only one saw their cancer recur, and 100% survived within three years.

In comparison, the control group had an 88% survival rate three years after surgery. Of the 45 patients in this group who received chemotherapy alone, nine relapsed, six of whom died.

“It is rare to achieve a 100% survival rate in a study like this, and for these aggressive types of cancer. We are extremely excited about the potential of this new approach, as it is crucial to find a way to treat and hopefully cure patients diagnosed with cancers linked to the BRCA1 and BRCA2 genes,” said Professor Jean Abraham, trial leader at Addenbroke’s Hospital, part of Cambridge University Hospitals (CUH).

These very promising results still need to be validated by a large-scale study.

But we can already imagine that this treatment could be applied to other cancers in which the BRCA genes are involved – ovarian, prostate and pancreatic.

How does Olaparib work ?

It is an inhibitor of PARP, a family of proteins involved in DNA repair, along with the BRCA protein. In triple-negative breast cancer, the BRCA 1 and BRCA 2 genes no longer function normally and no longer fulfill this repair role.

Mutated cells then rely on PARP for repair. But PARP inhibitors prevent the cancer cell from using it.

Without any available repair system, DNA errors accumulate. These errors cannot be repaired by either PARP or BRCA, leading to the death of cancer cells.

Source: University of Cambridge, Pactonco.fr