The OlympiAD trial demonstrated clinical benefit of olaparib in metastatic breast cancer patients who carry which germline mutation?

• A PIK3CA mutation in HR-positive HER2-negative disease
• B BRCA1 or BRCA2 germline mutation in HER2-negative disease ✓
• C PD-L1 overexpression in triple-negative disease
• D HER2 somatic mutation in HR-positive disease

Explanation

The OlympiAD trial showed that olaparib, a PARP inhibitor, significantly improved progression-free survival compared to standard chemotherapy in patients with metastatic HER2-negative breast cancer harboring germline BRCA1 or BRCA2 mutations. PARP inhibitors exploit synthetic lethality in BRCA-deficient tumors unable to perform homologous recombination repair. The other mutations are targeted by different agents (alpelisib for PIK3CA, pembrolizumab for PD-L1, neratinib for HER2 somatic mutations).

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

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