Adding veliparib to chemotherapy can extend progression-free survival in in some breast cancer patients

pharmafile | February 1, 2023 | News story | Research and Development  

It appears that adding veliparib to chemotherapy can extend progression-free survival (PFS) in patients suffering from triple negative breast cancer (TNBC) with a ‘BRCA-like’ phenotype. This conclusion follows results from the SWOG S1416 clinical trial, which was led by researchers at the SWOG Cancer Research Network.

The SWOG Cancer Research Network is funded by the National Cancer Institute (NCI), and the trial results were published in Lancet Oncology.

Veliparib is one of a class of drugs called PARP inhibitors, which appear effective in treating breast cancer with germline mutations in the BRCA1 or BRCA2 genes. This trial is the first which determines the efficacy of a PARP inhibitor in breast cancer without a BRCA1/2 mutation, despite being BRCA-like with the occurrence of various other changes which also impact the cells’ DNA repair abilities.

The trial included 320 patients with metastatic breast cancer, who were either given cisplatin chemotherapy with the PARP inhibitor veliparib, or cisplatin chemotherapy with a placebo dose. The researchers found that those treated with veliparib has a statistically significantly longer median PFS than those with the placebo: 5.9 months on veliparib compared to 4.2 months on the placebo dose. These patients also had a better overall survival time and objective response rate than those given the placebo.

Priyanka Sharma, MD, a SWOG investigator, professor of medicine at the University of Kansas Medical Center, US, and co-lead author on the paper, commented: “SWOG 1416 is the first trial to report benefit of a PARP inhibitor in metastatic TNBC with a BRCA-like phenotype in absence of germline mutations in BRCA1 or BRCA2 genes. BRCA-like phenotype is noted in 40 to 50 percent of triple negative breast cancers, making these findings and BRCA-like classification relevant for a substantial proportion of patients with TNBC.”

Sharma continued: “While these results are not immediately practice changing, since veliparib is not FDA approved, S1416 findings open new clinical trial directions by extending the patient population that could benefit from PARPi therapy. With demonstration of efficacy in BRCA-like phenotype TNBC, S1416 results provide a basis for expanding the therapeutic role of PARP inhibitors (e.g. veliparib) beyond germline BRCA mutation in breast cancer.”

Betsy Goodfellow

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