Topics:
Breast Cancer • Medical Oncology • NCI-CCC Tumor Board Question • University of Wisconsin • NCI-CCC Breast Tumor Board Question • BRCA+ • Breast Cancer, Non-metastatic • tnbc
What is your preferred adjuvant therapy for a patient with triple negative breast cancer and has a BRCA germline mutation who had minimal to no response to neoadjuvant chemotherapy?
Young patient, germline BRCA carrier with cT1cN0 to ypT2N0 disease after docetaxel/ cyclophosphamide x 4.
Answer from: Medical Oncologist at Academic Institution
The vast majority of OlympiA patients had both anthracycline and taxane therapy. Very few had less than 6 cycles of chemo or only one of the two agents. For this case, I would try to do 4 cycles of dose dense anthracycline treatments then adjuvant olaparib for 1 year.
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Answer from: Medical Oncologist at Academic Institution
This is a challenging situation. Some variation of this scenario comes up pretty routinely: e.g. a patient who would have qualified for more therapy post-operatively than given neoadjuvantly with substantial residual disease. Unfortunately, many of the adjuvant studies (CREATE-X, OlympiA) don't refl...