Systemic Therapy for Hereditary Breast Cancers

Hematol Oncol Clin North Am. 2023 Feb;37(1):203-224. doi: 10.1016/j.hoc.2022.08.018.

Abstract

Approximately 5% to 10% of all breast cancers are hereditary; many of which are caused by pathogenic variants in genes required for homologous recombination, including BRCA1 and BRCA2. Here we discuss systemic treatment for such breast cancers, including approved chemotherapeutic approaches and also targeted treatment approaches using poly-(ADP ribose) polymerase inhibitors. We also discuss experimental approaches to treating hereditary breast cancer, including new small molecule DNA repair inhibitors and also immunomodulatory agents. Finally, we discuss how drug resistance emerges in patients with hereditary breast cancer, how this might be delayed or prevented, and how biomarker-adapted treatment is molding the future management of hereditary breast cancer.

Keywords: Biomarkers; Chemotherapy; Drug resistance; Hereditary breast cancer; PARPi.

Publication types

  • Review

MeSH terms

  • Breast Neoplasms* / drug therapy
  • Breast Neoplasms* / genetics
  • Breast Neoplasms* / pathology
  • DNA Repair
  • Female
  • Genes, BRCA2
  • Humans
  • Poly(ADP-ribose) Polymerase Inhibitors / pharmacology
  • Poly(ADP-ribose) Polymerase Inhibitors / therapeutic use

Substances

  • Poly(ADP-ribose) Polymerase Inhibitors

Supplementary concepts

  • Breast Cancer, Familial