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The PARTNER trial of neoadjuvant olaparib in triple-negative breast cancer.

Jean E AbrahamKaren PinillaAlimu DayimuLouise GrybowiczNikolaos DemirisCaron HarveyLynsey M DrewettRebecca LuceyAlexander FultonAnne N RobertsJoanna R WorleyAnita ChhabraWendi QianAnne-Laure VallierRichard M HardySteve ChanTamas HickishDevashish TripathiRamachandran VenkitaramanMojca PersicShahzeena AslamDaniel GlassmanSanjay RajAnnabel BorleyJeremy P BraybrookeStephanie SutherlandEmma StaplesLucy C ScottMark DaviesCheryl A PalmerMargaret MoodyMark J ChurnJacqueline C NewbyMukesh B MukeshAmitabha ChakrabartiRebecca R RoylancePhilip C SchoutenNicola C LevittKaren McAdamAnne C ArmstrongEllen R CopsonEmma McMurtryMarc TischkowitzElena ProvenzanoHelena M Earl
Published in: Nature (2024)
PARTNER is a prospective, phase II-III, randomised controlled clinical trial, which recruited patients with Triple Negative Breast Cancer (TNBC) 1,2 , who were gBRCA wild type (gBRCAwt) 3 . Patients (n=559) were randomised on a 1:1 basis to neoadjuvant carboplatin with paclitaxel +/- olaparib 150mg twice daily, days 3 to 14, for 4 cycles (gap schedule olaparib, research arm) followed by 3 cycles of anthracycline chemotherapy before surgery. The primary endpoint was pathological complete response (pCR) 4 , and secondary endpoints included event-free survival (EFS), and overall survival (OS) 5 . pCR was achieved in 51% in the research arm and 52% in the control arm (p=0.753). Estimated EFS at 36 months in research and control arms were 80% and 79% (log-rank p>0.9); OS were 90% and 87.2% (log-rank p=0.8) respectively. In patients with pCR, estimated EFS at 36 months was 90%, and with non-pCR was 70% (log-rank p < 0.001) and OS was 96% and 83% (log-rank p < 0.001) respectively. Neo-adjuvant olaparib did not improve pCR rates, EFS or OS when added to carboplatin/paclitaxel and anthracycline chemotherapy in patients with TNBC (gBRCAwt). This is in marked contrast to the major benefit of olaparib (gap schedule) in those with gBRCA pathogenic variants (gBRCAm) which is reported separately (gBRCAm article). ClinicalTrials.gov ID NCT03150576.
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