奥拉帕利（奥拉帕尼）可改善转移性乳腺癌的生存

　　2017年8月22日，《美国医学会杂志》发表临床研究新闻报道：奥拉帕利可改善转移性乳腺癌的生存。

　　根据《新英格兰医学杂志》报道，对于种系BRCA突变和人表皮生长因子受体2（HER2）阴性转移性乳腺癌患者，奥拉帕利（奥拉帕尼）单药治疗与标准单药化疗相比，显著改善无进展生存。该三期研究首次表明，聚腺苷二磷酸核糖聚合酶（PARP）抑制剂不仅可使卵巢癌患者获益。PARP抑制剂通过干扰癌细胞DNA修复，引起癌细胞死亡。

　　该研究将既往接受转移病变化疗方案≤2种的302例患者，按2∶1随机分配接受奥拉帕利（奥拉帕尼，片剂，每天两次，每次300mg）或医师选择的标准单药化疗。

　　结果发现，奥拉帕利（奥拉帕尼）与标准治疗相比，中位无进展生存延长2.8个月，疾病进展或死亡风险减少42%，严重不良事件（贫血为主）发生率分别为36.6%、50.5%。

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JAMA. 2017 Aug 22;318(8):690.

Olaparib Increased Survival in Metastatic Breast Cancer.

Anita Slomski.

In patients with HER2-negative (human epidermal growth factor receptor type 2) metastatic breast cancer and a germline BRCA mutation, olaparib monotherapy significantly improved progression-free survival compared with standard single-agent chemotherapy. Reported in the New England Journal of Medicine, the phase 3 trial is the first in which a poly(adenosine diphosphate-ribose) polymerase (PARP) inhibitor has shown a significant benefit other than for patients with ovarian cancer. PARP inhibitors interfere with DNA repair in cancer cells, leading to cancer cell death.

The 302 patients, who had received no more than 2 previous chemotherapy regimens for metastatic disease, were assigned in a 2:1 ratio to receive olaparib tablets (300 mg twice daily) or standard chemotherapy of the physician's choice.

Median progression-free survival was 2.8 months longer and the risk of disease progression or death was 42% lower with olaparib than with standard therapy. The rate of severe adverse events (chiefly anemia) was 36.6% in the olaparib group and 50.5% in the standard-therapy group.

DOI: 10.1001/jama.2017.9824