la terapia sistemica antitumorale: quali novità nel setting … · 2019-10-07 · conclusions...
TRANSCRIPT
![Page 1: La terapia sistemica antitumorale: quali novità nel setting … · 2019-10-07 · Conclusions •How big is the issue: nearly 6% of all BC and nearly 15% in the subgroup ≤ 45 years](https://reader030.vdocuments.pub/reader030/viewer/2022041003/5ea4d0fab2007f7be840b81a/html5/thumbnails/1.jpg)
Roma, 4 Ottobre 2019
Relatore: Francesca Poggio
U.O. Oncologia Medica 2 IRCCS Ospedale Policlinico S. Martino, Genova
2019 CARCINOMA MAMMARIO: I TRAGUARDI RAGGIUNTI E LE NUOVE SFIDE
La terapia sistemica antitumorale: quali novità nel setting (neo)adiuvante?
Sessione 4: Il carcinoma mammario nelle donne con mutazione patogenetica BRCA1-2
![Page 2: La terapia sistemica antitumorale: quali novità nel setting … · 2019-10-07 · Conclusions •How big is the issue: nearly 6% of all BC and nearly 15% in the subgroup ≤ 45 years](https://reader030.vdocuments.pub/reader030/viewer/2022041003/5ea4d0fab2007f7be840b81a/html5/thumbnails/2.jpg)
Disclosure Information Relationship Relevant to this Session
Poggio, Francesca:
No relevant relationship to disclose.
![Page 3: La terapia sistemica antitumorale: quali novità nel setting … · 2019-10-07 · Conclusions •How big is the issue: nearly 6% of all BC and nearly 15% in the subgroup ≤ 45 years](https://reader030.vdocuments.pub/reader030/viewer/2022041003/5ea4d0fab2007f7be840b81a/html5/thumbnails/3.jpg)
• Introduction
• Neoadjuvant: platinum agents • Neoadjuvant: PARPi • (Neo)Adjuvant setting: ongoing trials
• Conclusions
Agenda
![Page 4: La terapia sistemica antitumorale: quali novità nel setting … · 2019-10-07 · Conclusions •How big is the issue: nearly 6% of all BC and nearly 15% in the subgroup ≤ 45 years](https://reader030.vdocuments.pub/reader030/viewer/2022041003/5ea4d0fab2007f7be840b81a/html5/thumbnails/4.jpg)
BRCA mutations carriers: The POSH study
POSH is the largest prospective cohort study to compare breast cancer
outcomes of patients with a BRCA1 or BRCA2 mutation with patients with
sporadic cancer.
Our findings showed that patients with young-onset breast cancer who have
a BRCA mutation have a similar overall survival to non-carriers. Copson ER, Lancet 2018
![Page 5: La terapia sistemica antitumorale: quali novità nel setting … · 2019-10-07 · Conclusions •How big is the issue: nearly 6% of all BC and nearly 15% in the subgroup ≤ 45 years](https://reader030.vdocuments.pub/reader030/viewer/2022041003/5ea4d0fab2007f7be840b81a/html5/thumbnails/5.jpg)
BRCA mutations carriers: Guidelines
![Page 6: La terapia sistemica antitumorale: quali novità nel setting … · 2019-10-07 · Conclusions •How big is the issue: nearly 6% of all BC and nearly 15% in the subgroup ≤ 45 years](https://reader030.vdocuments.pub/reader030/viewer/2022041003/5ea4d0fab2007f7be840b81a/html5/thumbnails/6.jpg)
• Introduction
• Neoadjuvant: platinum agents • Neoadjuvant: PARPi • (Neo)Adjuvant setting: ongoing trials
• Conclusions
Agenda
![Page 7: La terapia sistemica antitumorale: quali novità nel setting … · 2019-10-07 · Conclusions •How big is the issue: nearly 6% of all BC and nearly 15% in the subgroup ≤ 45 years](https://reader030.vdocuments.pub/reader030/viewer/2022041003/5ea4d0fab2007f7be840b81a/html5/thumbnails/7.jpg)
Neoadjuvant setting: Geparsixto
Hahnen E, JAMA Oncol 2017
![Page 8: La terapia sistemica antitumorale: quali novità nel setting … · 2019-10-07 · Conclusions •How big is the issue: nearly 6% of all BC and nearly 15% in the subgroup ≤ 45 years](https://reader030.vdocuments.pub/reader030/viewer/2022041003/5ea4d0fab2007f7be840b81a/html5/thumbnails/8.jpg)
Neoadjuvant setting: BrighTNess
Loibl S, Lancet 2018
~15% mBRCA
![Page 9: La terapia sistemica antitumorale: quali novità nel setting … · 2019-10-07 · Conclusions •How big is the issue: nearly 6% of all BC and nearly 15% in the subgroup ≤ 45 years](https://reader030.vdocuments.pub/reader030/viewer/2022041003/5ea4d0fab2007f7be840b81a/html5/thumbnails/9.jpg)
Neoadjuvant setting: BrighTNess
Loibl S, Lancet 2018
![Page 10: La terapia sistemica antitumorale: quali novità nel setting … · 2019-10-07 · Conclusions •How big is the issue: nearly 6% of all BC and nearly 15% in the subgroup ≤ 45 years](https://reader030.vdocuments.pub/reader030/viewer/2022041003/5ea4d0fab2007f7be840b81a/html5/thumbnails/10.jpg)
Neoadjuvant setting: BrighTNess
Loibl S, Lancet 2018
![Page 11: La terapia sistemica antitumorale: quali novità nel setting … · 2019-10-07 · Conclusions •How big is the issue: nearly 6% of all BC and nearly 15% in the subgroup ≤ 45 years](https://reader030.vdocuments.pub/reader030/viewer/2022041003/5ea4d0fab2007f7be840b81a/html5/thumbnails/11.jpg)
Meta-analysis platinum agents
∆pCR 15%!
Poggio F, Ann Oncol 2018
![Page 12: La terapia sistemica antitumorale: quali novità nel setting … · 2019-10-07 · Conclusions •How big is the issue: nearly 6% of all BC and nearly 15% in the subgroup ≤ 45 years](https://reader030.vdocuments.pub/reader030/viewer/2022041003/5ea4d0fab2007f7be840b81a/html5/thumbnails/12.jpg)
Meta-analysis platinum agents
BRCA-mutated patients
BRCA-negative patients
Poggio F, Ann Oncol 2018
![Page 13: La terapia sistemica antitumorale: quali novità nel setting … · 2019-10-07 · Conclusions •How big is the issue: nearly 6% of all BC and nearly 15% in the subgroup ≤ 45 years](https://reader030.vdocuments.pub/reader030/viewer/2022041003/5ea4d0fab2007f7be840b81a/html5/thumbnails/13.jpg)
• Introduction
• Neoadjuvant: platinum agents • Neoadjuvant: PARPi • (Neo)Adjuvant setting: ongoing trials
• Conclusions
Agenda
![Page 14: La terapia sistemica antitumorale: quali novità nel setting … · 2019-10-07 · Conclusions •How big is the issue: nearly 6% of all BC and nearly 15% in the subgroup ≤ 45 years](https://reader030.vdocuments.pub/reader030/viewer/2022041003/5ea4d0fab2007f7be840b81a/html5/thumbnails/14.jpg)
PARPi single agent
Litton J, J Clin Oncol 2019
![Page 15: La terapia sistemica antitumorale: quali novità nel setting … · 2019-10-07 · Conclusions •How big is the issue: nearly 6% of all BC and nearly 15% in the subgroup ≤ 45 years](https://reader030.vdocuments.pub/reader030/viewer/2022041003/5ea4d0fab2007f7be840b81a/html5/thumbnails/15.jpg)
First study of a single targeted therapy to achieve pCR in BRCA+ patients, including TNBC Talazoparib was well tolereted with acceptable adherence This study warrants the larger confirmatory trial
PARPi single agent: results
Litton J, J Clin Oncol 2019
![Page 16: La terapia sistemica antitumorale: quali novità nel setting … · 2019-10-07 · Conclusions •How big is the issue: nearly 6% of all BC and nearly 15% in the subgroup ≤ 45 years](https://reader030.vdocuments.pub/reader030/viewer/2022041003/5ea4d0fab2007f7be840b81a/html5/thumbnails/16.jpg)
GeparOla
Fasching AP, J Clin Oncol 2019
![Page 17: La terapia sistemica antitumorale: quali novità nel setting … · 2019-10-07 · Conclusions •How big is the issue: nearly 6% of all BC and nearly 15% in the subgroup ≤ 45 years](https://reader030.vdocuments.pub/reader030/viewer/2022041003/5ea4d0fab2007f7be840b81a/html5/thumbnails/17.jpg)
GeparOla: results
Fasching AP, J Clin Oncol 2019
![Page 18: La terapia sistemica antitumorale: quali novità nel setting … · 2019-10-07 · Conclusions •How big is the issue: nearly 6% of all BC and nearly 15% in the subgroup ≤ 45 years](https://reader030.vdocuments.pub/reader030/viewer/2022041003/5ea4d0fab2007f7be840b81a/html5/thumbnails/18.jpg)
GeparOla: results
Fasching AP, J Clin Oncol 2019
![Page 19: La terapia sistemica antitumorale: quali novità nel setting … · 2019-10-07 · Conclusions •How big is the issue: nearly 6% of all BC and nearly 15% in the subgroup ≤ 45 years](https://reader030.vdocuments.pub/reader030/viewer/2022041003/5ea4d0fab2007f7be840b81a/html5/thumbnails/19.jpg)
GeparOla: results
Fasching AP, J Clin Oncol 2019
![Page 20: La terapia sistemica antitumorale: quali novità nel setting … · 2019-10-07 · Conclusions •How big is the issue: nearly 6% of all BC and nearly 15% in the subgroup ≤ 45 years](https://reader030.vdocuments.pub/reader030/viewer/2022041003/5ea4d0fab2007f7be840b81a/html5/thumbnails/20.jpg)
(Neo)adjuvant setting
![Page 21: La terapia sistemica antitumorale: quali novità nel setting … · 2019-10-07 · Conclusions •How big is the issue: nearly 6% of all BC and nearly 15% in the subgroup ≤ 45 years](https://reader030.vdocuments.pub/reader030/viewer/2022041003/5ea4d0fab2007f7be840b81a/html5/thumbnails/21.jpg)
• Introduction
• Neoadjuvant: platinum agents • Neoadjuvant: PARPi • (Neo)Adjuvant setting: ongoing trials
• Conclusions
Agenda
![Page 22: La terapia sistemica antitumorale: quali novità nel setting … · 2019-10-07 · Conclusions •How big is the issue: nearly 6% of all BC and nearly 15% in the subgroup ≤ 45 years](https://reader030.vdocuments.pub/reader030/viewer/2022041003/5ea4d0fab2007f7be840b81a/html5/thumbnails/22.jpg)
PARPi in the adj setting OlympiA trial
Prior (neo)adjuvant platinum allowed
Recently completed 1836 BRCA carriers enrolled
![Page 23: La terapia sistemica antitumorale: quali novità nel setting … · 2019-10-07 · Conclusions •How big is the issue: nearly 6% of all BC and nearly 15% in the subgroup ≤ 45 years](https://reader030.vdocuments.pub/reader030/viewer/2022041003/5ea4d0fab2007f7be840b81a/html5/thumbnails/23.jpg)
INFORM trial: perioperative CDDP vs. AC
![Page 24: La terapia sistemica antitumorale: quali novità nel setting … · 2019-10-07 · Conclusions •How big is the issue: nearly 6% of all BC and nearly 15% in the subgroup ≤ 45 years](https://reader030.vdocuments.pub/reader030/viewer/2022041003/5ea4d0fab2007f7be840b81a/html5/thumbnails/24.jpg)
• Introduction
• Neoadjuvant: platinum agents • Neoadjuvant: PARPi • (Neo)Adjuvant setting: ongoing trials
• Conclusions
Agenda
![Page 25: La terapia sistemica antitumorale: quali novità nel setting … · 2019-10-07 · Conclusions •How big is the issue: nearly 6% of all BC and nearly 15% in the subgroup ≤ 45 years](https://reader030.vdocuments.pub/reader030/viewer/2022041003/5ea4d0fab2007f7be840b81a/html5/thumbnails/25.jpg)
Conclusions
• How big is the issue: nearly 6% of all BC and nearly 15%
in the subgroup ≤ 45 years or TNBC regardless the age • Current guidelines did not recommend a specific
treatment for BRCA-mutated in the early setting • Tha addition of platinum to neoadjuvant chemotherapy
may be considered an option for unselected TNBC • Results of ongoing trials are awaited to clarify the role
of PARPi in the (neo)adjuvant setting