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?

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.

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...