Experience of using talazoparib in the aggressive course of BRCA2-associated triple-negative breast cancer: a clinical observation

Abstract

The median overall survival for patients with metastatic triple-negative breast cancer is about 12-14 months. Chemotherapy has been the only treatment option for this tumour subtype for a long time, irrespective of immunological and genetic characteristics. Straightforward therapy algorithms have not been defined, and the optimum sequencing of chemotherapy regimens is left to the discretion of the attending physician. Today, impressive findings from clinical studies on the use of immunotherapy and targeted therapy for cancer using PARP inhibitors reflect in current guidelines, raising the chances of patients to prolong life and maintain its high quality. Thus, the use of immunotherapy as first-line treatment of PD-L1-positive tumours allowed to significantly increase the overall survival of patients for the first time in many years. And the use of PARP inhibitors in carriers of BRCA1/2 germline mutations not only significantly prolongs progression-free survival, but also improves quality of life versus standard chemotherapy regimens. The benefit is also observed in patients with an aggressive course of the disease such as damage to the visceral organs and the central nervous system. The presence of BRCA1/2 germline mutations in the genes, damage to the CNS and visceral organs is associated with an extremely unfavourable prognosis and a significant decline in life expectancy. However, a high-quality diagnosis before initiation of treatment, creating proper treatment plans and the use of modern opportunities can improve the outcomes of treatment. The article discusses possible treatment options for metastatic TNBC, reflects current guidelines on the use of immuno- and targeted therapy. A clinical case report of the treatment of a patient with a significantly aggravated history and an aggressive course of TNBC is presented. The patient with visceral metastases, brain damage and early progression after primary treatment has been receiving therapy for two years, while maintaining a satisfactory quality of life.