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Three additional agents became available in 2021 for use in the curative setting for patients with high-risk breast cancer: olaparib, abemaciclib, and pembrolizumab.

Hormonally driven breast cancer may be particularly sensitive to inhibition of cell cycle regulatory proteins, called cyclin dependent kinases 4 and 6 (CDK 4/6). Three oral CDK4/6 inhibitors—palbociclib, ribociclib, and abemaciclib—are FDA-approved for treatment of HR-positive, HER2-negative metastatic breast cancer.

Two poly(ADP-ribose) polymerase (PARP) inhibitors (olaparib and talazoparib) are FDA-approved for the treatment of BRCA-associated metastatic breast cancer. The NCCN guidelines include adjuvant olaparib for select patients and recommend germline genetic testing for any patient who may be a candidate for adjuvant olaparib.

Schmid P et al; KEYNOTE-522 Investigators. N Engl J Med. [PMID: 32101663]

Tutt ANJ et al; OlympiA Clinical Trial Steering Committee and Investigators. N Engl J Med. [PMID: 34081848]

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