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YOUR HEALTH: An old drug working for some breast cancer patients

A treatment already in use for some forms of cancer may keep breast cancer from coming back

PITTSBURGH — A woman who tests positive for the BRCA1 or 2 gene has a 60% to 70% chance of developing breast cancer in her lifetime.

These patients are also one and a half times more likely to have cancer come back.

"What they wanted to do in the OlympiA trial is take those patients who are BRCA positive and give them a PARP inhibitor to see if it would prevent recurrence," said medical oncologist Dr. adam Brufsky.

As part of the trial, the PARP inhibitor, olaparib, also known as Lynparza, was given to 1800 patients with early stage, BRCA one and two positive, HER-two negative cancer.

Patients took the drug for a year after chemotherapy.

"They get chemo, have residual disease, get the drug and have survival. I think it was like 85% at three years versus 77%," said Dr. Brufsky.

"It was pretty substantial, 6% is a lot in our business."

Scientists have identified a mutation that gives cancer cells resistance to the breakthrough cancer treatment olaparib, and other PARP inhibitors. 

The findings could help predict which patients will develop resistance to PARP inhibitors and allow doctors to alter treatment at the earliest possible opportunity. 

The scientists used new 'CRIPSR-Cas9' gene editing technology to generate mutations in small, targeted sections of the PARP1 gene, and tagged the mutant protein with a fluorescent protein so their effects could be tracked. 

This approach allowed the researchers to observe the effect of specific mutations on PARP1 and on the sensitivity of cancer cells to PARP inhibitors.

The researchers found that, contrary to their original predictions, cancer cells with certain mutations in the BRCA1 gene could survive this loss of PARP1's DNA repair function, making them resistant to PARP inhibitors.

Lynparza is currently FDA approved in the US for use in patients with metastatic breast cancer but had not been fully studied in women with early-stage cancer until now.

"This we believe is probably going to change the standard of care," said Dr. Brufsky.

If this story has impacted your life or prompted you or someone you know to seek or change treatments, please let us know by contacting Jim Mertens at jim.mertens@wqad.com or Marjorie Bekaert Thomas at mthomas@ivanhoe.com.

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