Treatments for Breast Cancer With a Certain Genetic Mutation: PARP Inhibitors
In January 2018, the FDA approved the first treatment for breast cancer with a certain inherited genetic mutation. Called Lynparza (chemical name: olaparib), it is the first PARP inhibitor to treat breast cancer.
The PARP (poly ADP-ribose polymerase) enzyme fixes DNA damage in cells, including DNA damage caused by chemotherapy medicines. According to breastcancer.org, the idea behind PARP inhibitors is that it may be able to stop cancer cells from healing their DNA damaged by chemotherapy.
“This class of drugs has been used to treat advanced, BRCA-mutated ovarian cancer and has now shown efficacy in treating certain types of BRCA-mutated breast cancer,” said Richard Pazdur, M.D., director of the FDA’s Oncology Center of Excellence. “This approval demonstrates the current paradigm of developing drugs that target the underlying genetic causes of a cancer, often across cancer types.”
Recent research shows that PARP inhibitor monotherapy provides significant benefit over standard therapy for patients with BRCA mutation and HER2-negative metastatic breast cancer. The research showed that the PARP inhibitors reduced the chance of progression of advanced BRCA-related breast cancer by 42%, and delayed progression by 2.8 months. Researchers are now exploring whether these PARP inhibitors could also be used in different subsets of breast cancer, such as triple negative breast cancer.
Sources: American Society of Clinical Oncology (ASCO), breastcancer.org, FDA
Muscle Sparing Reconstruction: Prepectoral Implants
Breast reconstruction is traditionally submuscular, meaning that if an implant is used, it is placed under the chest muscle. This procedure involves cutting some of the chest muscle to be able to place the implant underneath. A less invasive option is emerging called prepectoral implant reconstruction. Prepectoral implant-based surgery works by placing the implant directly under the skin and over the muscle. An acellular dermal matrix covers the implant.
Research suggests that for the right patients, this new technique is safe, feasible, and has excellent short-term outcomes. The big benefits are that it avoids deformity, and has a lower incidence of capsular contracture, which is when internal scar tissue forms a tight or constricting capsule around a breast implant, causing it to contract and become misshapen and hard.
Not all patients are a fit for this type of breast reconstruction, however. Breast size and flap assessment are factors. More research needs to be conducted on the long-term effects as well.