Groundbreaking new treatment for aggressive breast cancer has 100% survival rate

Hope is on the horizon for patients with aggressive, inherited breast cancers.

A recent clinical trial, led by researchers at Cambridge University, explored the effects of combining chemotherapy with the targeted cancer drug olaparib before surgery.

Every patient who received this protocol survived the critical three-year post-treatment period.

The research, published in Nature Communications, suggests this preemptive, two-part approach could be the most effective plan of treatment for early-stage breast cancer linked to BRCA1 and BRCA2 gene mutations.

Breast cancer or BRCA genes are present in every cell of the human body. When functioning, BRCA1 and BRCA2 repair DNA and prevent cancerous changes.

However, when a mutation compromises these genes, cancer risk increases. Inheriting this damaged DNA can increase the risk for breast and ovarian cancer in women and breast and prostate cancer in men.

BRCA1 or BRCA2 genes are more common in young women, and these mutations increase cancer risk by as much as 84%. Six percent of all breast cancer patients carry BRCA gene mutations, but in patients under 45, roughly 12% carry the gene.

BRCA cancers are notoriously aggressive and difficult to treat.

In 2013, Angelina Jolie, who carries the faulty BRCA1 gene, made headlines when she underwent a preventative double mastectomy. As a result of the procedure, Jolie, who lost her own mother to breast cancer, saw her chances of developing breast cancer drop from 87 percent to less than 5 percent.

The current protocol for treating BRCA cancers includes shrinking the tumour using chemotherapy and immunotherapy, before removing it through surgery.

The first three years after surgery — when there is the greatest risk of relapse or death — are critical.

The trial recruited patients from across the UK and aimed to test the efficacy of combining chemotherapy with olaparib before surgery and carefully timing when these treatments were administered.

The study revealed that allowing a 48-hour “gap” between chemotherapy and olaparib treatments led to more positive outcomes. Researchers believe this interval allows the patient’s bone marrow to recover from chemo while leaving tumor cells receptive to olaparib.

Olaparib, sold under the brand name Lynparza, is typically taken for 12 months post-surgery. However, trial patients took the tablets pre-surgery for a period of 12 weeks.

The survival rate among the control group who received chemotherapy alone was 88%. Of these 45 patients, nine relapsed and six died within three years of surgery.

In contrast, there was a 100% survival rate among the 39 patients who received chemotherapy followed by olaparib. Of this cohort, only one patient relapsed in the three years following surgery.

“It is rare to have a 100% survival rate in a study like this and for these aggressive types of cancer,” said trial lead Professor Jean Abraham.

“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.”

Compared to current care protocols, the two-pronged approach of chemo and olaparib pre-surgery offers a more cost-effective and less toxic treatment for patients.

Abrahams and his team are planning the next research phase, which will aim to replicate their results in a larger study.

They are hopeful their findings can and will be applied to treat other cancers caused by mutated BRCA genes, including some ovarian, prostate, and pancreatic cancers.

Breast cancer is the most common cancer among US women after skin cancer. About 1 in 8 women will be diagnosed with breast cancer in their lifetime. 

Though breast cancer starts in a localized part of the breast tissue, it can spread to other areas of the body, significantly decreasing rates of survival.

Survival rates among breast cancer patients whose cancer is detected before it spreads are high, between 86% and 89%. Yet if the cancer is detected after the cancer cells have migrated, that number drops to 31%.