Oliparib seems to garnering lots of interest. check this link form clinicaltrials.gov

https://clinicaltrials.gov/ct2/results?term=olaparib+and+breast&Search=Search

Big Changes Coming in Treatment of Triple-Negative Breast Cancer 

The treatment paradigm for patients with triple-negative breast cancer (TNBC) is set to undergo a dramatic transformation, as standard chemotherapeutic approaches are perfected and novel antibody-drug conjugates (ADCs) are developed. Kimberly Blackwell addressed this topic at the 2015 Chemotherapy Foundation Symposium, a meeting of over 1,000 oncologists and oncology professionals in New York City in November.

“I think we will see significant improvements in triple-negative breast cancer within the next few years,” said Blackwell, an oncologist at the Duke Cancer Institute. “There are two ADCs that I am fairly excited about that are in late stage development.”

Refining Chemotherapy for TNBC

In a phase 3 trial,1 labeled Study 301, Halaven (eribulin mesylate) was compared with the chemotherapy capecitabine in previously treated patients with locally advanced or metastatic breast cancer. Patients were randomized to receive Halaven at 1.4 mg/m2 on days 1 and 8 (554 patients) or capecitabine at 1250 mg/m2 on days 1 to 14 (548patients).

Across the full population of the study, Halaven was not found to be superior to capecitabine for the coprimary endpoints of overall survival (OS) and progression-free survival (PFS). However, in a preplanned subgroup analysis of those with TNBC, a distinct advantage was seen.

“The one thing where this study actually changed my practice was this planned subgroup analysis of those women with triple-negative metastatic breast cancer,” Blackwell said. “This study validates that [intravenous] chemotherapy might be valuable in this population of first-line triple-negative breast cancer.”

In patients with TNBC (284 patients), there was a five-month improvement in OS with Halaven versus capecitabine. Median OS was 14.4 versus 9.4 months, for Halaven and capecitabine, respectively.

“When you see an overall survival advantage in the setting of women facing metastatic or incurable disease, you have to sit up and take note,” said Blackwell. "This study actually did shape my practice quite a bit, in terms of triple-negative breast cancer."

In a second phase 3 study,2 labeled TNT, 376 patients with triple-negative or known BRCA1/2 mutation-positive metastatic breast cancer were treated with first-line chemotherapy (docetaxel or carboplatin). Patients were randomized to receive carboplatin at AUC 6 every three weeks (188 patients) or docetaxel at 100 mg/m2 every three weeks (188 patients). Crossover was planned between the two arms following progression.

Across all patient groups, the objective response rate (ORR) with carboplatin was 31.4 percent compared with 35.6 percent for docetaxel. Following crossover similar findings were demonstrated.

“The only real difference in this study — that was very intriguing but validated some of the things were had been thinking — is that for those women facing breast cancer in the setting of a BRCA 1 or 2 mutations, the response rate was double, in favor of carboplatin over docetaxel,” Blackwell said.

In those with BRCA1/2-mutant breast cancer, ORR with carboplatin was 68.0 percent compared with 33.3 percent for docetaxel. In this same population, the median PFS with carboplatin was 6.8 versus 4.8 months with docetaxel. In the absence of BRCA1/2 mutations, the ORR with carboplatin was 28.1 percent versus 36.6 percent with docetaxel.

“This is the second randomized trial that basically changed my practice, in that it really demonstrated a role for platinums versus taxanes in women harboring a deleterious BRCA1/2 mutations,” Blackwell said. - See more at: http://www.curetoday.com/articles/big-changes-coming-in-treatment-of-triple-negative-breast-cancer#sthash.AlKHpRPv.dpuf

http://www.curetoday.com/articles/big-changes-coming-in-treatment-of-triple-negative-breast-cancer