Drug combination gives hope to patients with BRCA-related breast cancer

A new combination treatment has yielded 100 percent survival for patients with 'aggressive' breast cancers, three years post-surgery.

A Cambridge-led clinical trial shows that using existing drugs in a new regimen may enhance survival rates for inherited breast cancers, such as those driven by BRCA mutations. Three years after treatment, the patients who recieved the new regimen demonstrated reduced rates of cancer returning and 100 percent survival, compared to 88 percent in the control group.

Professor Jean Abraham – study leader and lead author of the research published in Nature Communications – said: 'It is rare to have a 100 percent survival rate in a study like this and for these aggressive types of cancer. We’re incredibly excited about the potential of this new approach, as it’s crucial that we find a way to treat and hopefully cure patients who are diagnosed with BRCA1 and BRCA2 related cancers.' Professor Abraham is a consultant oncologist at Addenbrooke's hospital, and professor of oncolology at the University of Cambridge.

Patients were recruited across 23 hospitals in England, Scotland and Wales. The trial compared 39 women on the new regimen with a control group of 45 treated with only chemotherapy. Patients in both groups also had their tumours surgically removed.

The new regimen involved administering the anticancer drug Olaparib exactly 48 hours after patients were treated with the chemotherapy combination CarboTaxol, prior to surgery. Olaparib is a targeted treatment for cancers carrying BRCA mutations, but is usually only offered after surgery.

Until now it was not possible to use these drugs in combination due to the risk of significantly damaging patient's bone marrow. The clinical trial overcame this barrier by identifying an optimal 'gap' of 48 hours between when patients receive the drugs. The reserchers believe that this gap allows time for the bone marrow to recover, avoiding toxicity. Additional data indicated that the specific order in which the drugs were administered was also crucial for effective treatment.

In addition to the increased survival in the group receiving Olaparib pre-operatively, only one patient treated with the new regime relapsed, compared to nine in the control group.

Olaparib is currently offered to cancer patients by the NHS for 12 months post-surgery, to reduce the risk of cancer recurrence. The pre-operative Olaparib regime provides the drug for only 12 weeks, offering potential cost-saving benefits for the NHS alongside improved therapeutic outcomes.

Co-author Dr Mark O'Connor, chief scientist in oncology at AstraZeneca, said: 'While the findings need to be validated in a larger study, they’re incredibly exciting, and have the potential to transform outcomes for patient populations who have unmet clinical need.'

The research team are now planning to launch a larger multinational trial with 600 patients to build on these results.