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June 16, 2021
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ASCO updates guideline for hereditary breast cancer

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ASCO issued a guideline update that recommends offering 1-year of adjuvant olaparib to certain patients with breast cancer.

The recommendation applies to patients with high-risk, early-stage, HER2-negative breast cancer and germline BRCA mutations who completed neoadjuvant chemotherapy and local treatment, including radiation.

The recommendation updates a guideline on hereditary breast cancer management that ASCO, Society of Surgical Oncology and American Society for Radiation Oncology issued in 2020.

The updated guidance incorporates findings of the randomized phase 3 OlympiA trial, presented at this year’s virtual ASCO Annual Meeting and published simultaneously in The New England Journal of Medicine.

As Healio previously reported, results showed 1 year of adjuvant olaparib (Lynparza, AstraZeneca) — a poly(ADP-ribose) polymerase (PARP) inhibitor — significantly extended invasive and distant DFS in this patient population compared with placebo. The regimen also exhibited an acceptable toxicity profile.

The “clear and positive data” prompted ASCO to release a provisional update to its guideline recommendation that focuses specifically on the use of olaparib in this treatment setting, according to a society-issued press release.

A formal assessment and submission of the guideline update for publication in Journal of Clinical Oncology will follow, according to the release.

Clifford A. Hudis, MD, FACP, FASCO
Clifford A. Hudis

“Guideline updates have traditionally required months to review new data, assemble an expert panel, develop, approve and publish recommendations — making it difficult to provide timely support to clinicians seeking to keep abreast of rapidly advancing research,” Clifford A. Hudis, MD, FACP, FASCO, ASCO’s CEO, said in the release. “ASCO’s new rapid guideline-updating strategy is meant to address this need by providing rapid evidence review and dissemination of practice-changing trial results.”

References:

ASCO. ASCO releases rapid guideline recommendation update for certain patients with hereditary breast cancer. Available at: https://www.asco.org/about-asco/press-center/news-releases/asco-releases-rapid-guideline-recommendation-update-certain. Accessed June 16, 2021.
ASCO. Management of hereditary breast cancer: Provisional guideline recommendation update. Available at: www.asco.org/research-guidelines/quality-guidelines/guidelines/breast-cancer#/143725. Accessed June 16, 2021.