How an FDA-approved breast cancer drug could help treat other cancers

A drug used to treat breast cancer patients could be useful against a wide variety of other cancers, according to a recent study presented to the American Society of Clinical Oncology.

The phase 2 study evaluated the use of the drug talazoparib in 28 cancer patients with 16 different tumor types. While the origin of their cancer varied – including breast, colorectal, liver, lung, pancreas, skin, stomach and uterus – it was the patients’ specific genetic mutation that they had in common.

Each of the patients had an advanced stage of the disease. They had been heavily pretreated, had exhausted all other standard treatment options, and were going into palliative care.

The researchers expected a disease control rate of around 15%, meaning the cancer shrank or stabilized over the four-month study. Instead, they reported a 57% control rate, with 36% showing shrinkage of their tumor.

“No one expected such a high response rate,” said Dr. Gordan Srkalovic, medical director of Sparrow Herbert-Herman Cancer Center in Lansing.

“We found that there are opportunities to use a currently approved drug in a broader sense, in more cancers than approval is made, which means more patients could be effectively treated with a drug. specific and it opens up more possibilities for patients to be effective treatment.”

Talazoparib is called a poly-ADP ribose polymerase or PARP inhibitor. The United States Food and Drug Administration approved it in 2018 to treat BRCA-mutated breast cancer. Then this summer, its approval was expanded to treat a specific form of genetically mutated prostate cancer.

Normally, the BRCA1 and BRCA1 genes produce proteins that help repair damaged DNA. These are tumor suppressor genes passed down from parents.

However, mutations in these genes – some of which are inherited – can allow cells to grow out of control. These mutations are known to increase a person’s likelihood of developing breast, ovarian, prostate, and other cancers.

“When you have a mutation in those genes, that repair is inadequate,” Srkalovic said.

The BRCA1/2 genes are not the only genes that can be mutated in an individual with cancer. But the research team focused on this particular mutation to evaluate the use of PARP inhibitors like talazoparib in the fight against cancer.

Their findings suggest that cancer patients who are screened and have the BRCA gene mutation in their cancer cells may, in the future, be candidates for talazoparib or other PARP inhibitors if the drugs gain broader regulatory approval. federal.

“It’s becoming the core problem in oncology and we’re really looking more to start treating patients based on mutations in their cancer cells, rather than treating based on the organ of origin,” Srkalovic said.

“We treat breast cancer, prostate cancer, lung cancer differently, but it is possible that among these cancers there are cases that have the same genetic mutations and if we treat according to the genetic mutations, all these patients would be treated in the same way.”

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