Would you consider use of PARP inhibitors in patients with metastatic breast cancer with moderate penetrance germline mutations such as CHEK2, ATM, RAD51?

In the Olaparib Expanded (TBCRC 048) study published by @Dr. First Last in JCO, there were no responses to olaparib in metastatic breast cancer with germline or somatic CHEK2 or ATM pathogenic variants (mutations). In contrast, responses were seen in metastatic breast cancer with PALB2 pathogenic va...

There are limited data about the use of PARP inhibitors in women with moderate penetrance alterations. Those data suggest that cancers associated with PALB2 alterations are highly sensitive to PARP inhibitors. However, alterations in the other genes such as ATM and CHEK2 do not appear to be sensitiv...

There's no evidence to treating patients with CHEK2 mutation with PARP inhibitors.