Safety and tolerability of olaparib combined with breast radiotherapy in patients with triple-negative breast cancer: Final results of the RADIOPARP phase 1 trial.

Authors

null

Pierre Loap

Institute Curie, Department of Radiation Oncology, Paris, France

Pierre Loap , Delphine Loirat , Frederique Berger , Manuel Rodrigues , Louis Bazire , Jean-Yves Pierga , Anne Vincent-Salomon , Fatima Laki , Latifa Boudali , Laurence Raizonville , Veronique Mosseri , Anne Jochem , Mamadou Diallo , Marc-Henri Stern , Alain Fourquet , Youlia M. Kirova

Organizations

Institute Curie, Department of Radiation Oncology, Paris, France, Medical Oncology Department and D3i, Institut Curie, Paris, France, Institut Curie, Biostatistics Unit, Paris, France, Medical Oncology, Institut Curie, Paris, France, Institut Curie, Department of Radiation Oncology, Paris, France, Institut Curie, Department of Medical Oncology, Paris, France, Institut Curie, Department of Pathology, Paris, France, Institut Curie, Department of Surgery, Paris, France, Institut Curie, Department of Genetics, Paris, France

Research Funding

Pharmaceutical/Biotech Company

Background: Preclinical studies have demonstrated that triple-negative breast cancer (TNBC) cells were sensitive to PARP inhibitors when used as radiosensitizers. Combining PARP-inhibitors with radiotherapy may consequently enhance the biological effectiveness of the irradiation, leading to improved locoregional control in TNBC patients. We aimed to establish the appropriate dosing and the safety profile of Olaparib used as a radiosensitizer in combination with radiotherapy in TNBC patients with residual disease after neoadjuvant chemotherapy. Methods: RADIOPARP (NCT03109080) was a prospective phase I dose-escalation trial establishing the tolerance profile of Olaparib combined with breast radiotherapy in high-risk early TNBC patients. Inclusion criteria were resected TNBC with non-complete pathological response after neoadjuvant chemotherapy, or unresectable TNBC despite prior neoadjuvant chemotherapy. Olaparib was started seven days before irradiation and continued during radiotherapy. A time-to-event continual reassessment method was used to increase Olaparib through four increasing dose levels (50mg, 100mg, 150mg or 200mg twice a day) with a 25% maximum probability rate of dose-limiting toxicities (DLT). Radiotherapy delivered 50 Gy to the breast or to the chest wall, with or without lymph node irradiation. Toxicities were graded according to CTCAE (version 4.03). Homologous recombination (HR) proficiency status was genetically determined based on shallow whole genome sequencing. Results: Twenty-four TNBC patients were enrolled between 09/2017 and 11/2019. Olaparib was escalated to 200 mg twice a day without DLT and the MTD was not reached. With a median follow-up of 34 months, no late treatment-related grade ≥ 3 toxicity was observed, and the maximum observed toxicities were limited to grade 2 breast pain (n=2), fibrosis (n=2), deformity (n=1) and telangiectasia (n=1). Three-year OS and EFS were 83% [95% CI: 70%-100%] and 65% [51%-91%], respectively. HR proficiency status was not associated with OS and EFS. Conclusions: Olaparib used as a radiosensitizer in combination with radiotherapy in TNBC patients was well-tolerated. The MTD was not reached, and no significant late toxicity was reported. For future trials evaluating the anti-tumor efficacy of this combination, an Olaparib dose of 200 mg twice a day should be considered. Clinical trial information: NCT03109080.

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Abstract Details

Meeting

2022 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Breast Cancer—Local/Regional/Adjuvant

Track

Breast Cancer

Sub Track

Adjuvant Therapy

Clinical Trial Registration Number

NCT03109080

Citation

J Clin Oncol 40, 2022 (suppl 16; abstr 534)

DOI

10.1200/JCO.2022.40.16_suppl.534

Abstract #

534

Poster Bd #

306

Abstract Disclosures