(Breast Cancer) Is Imfinzi + Lynparza Effective?
Medical Supporter — Information Notice
This article is a summary of international medical information and is not medical advice; it cannot replace the diagnosis or treatment plan of your attending physician. The medical technologies, drug information and clinical data presented here are compiled from public literature and official statements of major Japanese medical institutions; the applicability and outcome of any therapy vary with each patient and must be assessed individually by a qualified physician.
On August 6, 2020, Susan M. Domchek published in The Lancet the efficacy and safety results of the MEDIOLA Phase 1/2 clinical trial evaluating anti-PD-L1 antibody Imfinzi (durvalumab) + PARP inhibitor Lynparza (olaparib) in BRCA1/BRCA2 mutation-positive breast cancer patients.
The MEDIOLA trial was an open-label multicenter trial. BRCA1/BRCA2 mutation-positive breast cancer, ovarian cancer, gastric cancer, and recurrent small cell lung cancer patients received Imfinzi (1500mg) + Lynparza (300mg twice daily) combination therapy in 4-week cycles. Primary endpoints were safety, tolerability, and 12-week disease control rate. Breast cancer patients were required to have received at least 2 previous chemotherapy regimens to participate.
Previous clinical trials had confirmed that PARP inhibitors combined with VEGFR inhibitors showed higher anti-tumor efficacy. This trial evaluated the efficacy and safety of Imfinzi + Lynparza specifically in BRCA1/BRCA2 mutation-positive breast cancer patients.
In the analyzed 34 patients, the primary endpoint safety showed Grade 3+ adverse events in 32% (N=11 patients). The most common symptoms were anemia 12% (N=4), neutropenia 9% (N=3), and pancreatitis 6% (N=2). Treatment discontinuation rate due to adverse events was 12% (N=4), with no treatment-related deaths. Among 30 analyzed patients, the disease control rate at 12 weeks of treatment was 80%.
Based on MEDIOLA clinical trial results, Alice T. Shaw concluded that BRCA1/BRCA2 mutation-positive breast cancer patients showed good tolerability with anti-PD-L1 antibody Imfinzi + PARP inhibitor Lynparza combination, with promising anti-tumor efficacy. However, further research is needed to determine if Imfinzi combination therapy provides better long-term clinical outcomes than Lynparza monotherapy.
Source: Olaparib and durvalumab in patients with germline BRCA-mutated metastatic breast cancer (MEDIOLA): an open-label, multicentre, phase 1/2, basket study (Lancet Oncol. 2020 Aug 6;S1470-2045(20)30324-7. doi: 10.1016/S1470-2045(20)30324-7)
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