Expert Discusses The Value of Combination Treatment in TNBC Treatment


The future of treating patients with triple-negative breast cancer is bright, but more needs to be done to address mutations early on in the course of the disease.

The number of therapeutic options for patients with triple-negative breast cancer (TNBC) is seemingly increasing rapidly, but the focus of these new treatments must turn from treatment later on in the disease course to right at diagnosis, according to Hope Rugo, MD.

In a presentation at the 2019 Lynn Sage Breast Cancer Symposium Rugo, director of Breast Oncology and Clinical Trials Education at the University of California, San Francisco Helen Diller Family Comprehensive Cancer Center, discussed moving treatments of TNBC to earlier in the disease course to avoid mutations from treatment. One treatment Rugo discussed was the combination of PARP inhibitor olaparib (Lynparza) with immunotherapy after patients have undergone chemotherapy for an indication.

OncLive® a sister publication to Oncology Nursing News® had the chance to sit down with Rugo after her presentation and discuss the value of combination treatments for patients with TNBC and where she believes studies in this space are heading.


There was a marked increase in the rate of grade 3 thrombocytopenia with the addition of olaparib, but otherwise, the toxicities are relatively similar. What happens in terms of long term data with that trial will, I think, really determine how we use that that combination, but what's intriguing to me is the concept of getting an induction with chemotherapy, plus or minus a checkpoint inhibitor, and then using the PARP inhibitor may be combined with immunotherapy as maintenance.

Similar to what's been done in ovarian cancer, there actually is very interesting data from the laboratory suggesting that the combination of PARP inhibitors and checkpoint inhibitors will enhance the efficacy of checkpoint inhibitors. So, the PARP inhibitors increase the sort of immune responsiveness of the tumor micro-environment by a variety of mechanisms and there actually are a number of studies going on looking at those combinations as well, with some early encouraging data.

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