When would you consider adding adjuvant PARP inhibitor in a young gBRCA mutated patient with HR+,HER2- early breast cancer?

At this time, I would only consider this in the setting of a clinical trial, such as OlympiA (NCT02032823), given that this strategy has not yet been proven to improve outcomes in the early stage setting. These agents are very promising in the neoadjuvant setting, as highlighted by a small pilot study of 20 patients recently published by Litton et al in JCO. However their use in this setting is still experimental.